2 research outputs found
Is high accuracy of Vesical Imaging-Reporting and Data System (VI-RADS) sufficient for its implementation in the urological practice?
Aims. Currently, the only method used to differentiate between MIBC and NMIBC is transurethral resection of the
bladder tumour (TURBT). Magnetic resonance and Vesical Imaging-Reporting and Data System (VI-RADS) would allow
for discrimination between NMIBC and MIBC. We evaluate the sensitivity and specificity of VI-RADS in the diagnosis of
muscle-invasive bladder cancer and discuss its value in everyday urological practice.
Methods. 64 patients with bladder cancer (BC) were enrolled into this prospective study. Multiparametric magnetic
resonance imaging (mpMRI) was performed before transurethral resection of the bladder tumour (TURBT) and evalu ated using the VI-RADS score. Score were compared to histopathology results. We evaluated the sensitivity, specificity,
positive and negative predictive value of this system using both cut-off VI-RADS ≥ 3 and ≥ 4.
Results. Sensitivity of 92.3% (95%CI: 64.0; 99.8), specificity of 81.4% (95%CI: 69.1; 90.3), positive predictive value of
52.2% (95%CI: 30.6; 73.2) and negative predictive value of 98.0% (95%CI: 89.1; 99.9) was determined using cut off VI RADS ≥ 3, while sensitivity of 76.9% (95%CI: 46.2; 95.0), specificity of 91.5% (95%CI: 81.3; 97.2), positive predictive value
of 66.7% (95%CI: 38.4; 88.2), and negative predictive value of 94.7% (95%CI: 85.4; 98.9) was determined using cut-off
VI-RADS ≥ 4. Based on our results, we consider the optimal cut-off point to be VI-RADS ≥ 3 with the overall prediction
accuracy of 83.3% (95%CI: 72.7; 91.1).
Conclusions. We acknowledge that mpMRI provides valuable information with regard to BC staging, however, despite
its high overall accuracy, we do not consider the VI-RADS could replace TURBT in discrimination between non-muscle
invasive and MIBC.Web of Science1671908
Risk of genitourinary malignancy in patients that receive anticoagulant or antiplatelet therapy
OBJECTIVES: Haematuria is a common indication for a urology evaluation. In many cases, its cause is not
determined unequivocally, but it does not pose any threat to the patient. However, it can represent the fi rst
symptom of urinary tract cancer.
BACKGROUND: The present study aimed to compare the risk of urological malignancies in patients with
haematuria who received antiplatelet or anticoagulant therapy versus those who did not.
METHODS: This prospective study included 562 patients with haematuria during the period of 2018‒2021.
Among these, 129 patients had macroscopic haematuria. All patients underwent a urinary tract ultrasound,
CT with urography, and cystoscopy. Patients with suspected malignancy underwent an appropriate surgical
procedure with a pathology examination. Data were analysed with univariate and multiple logistic regression.
RESULTS: The incidence rates of malignancies were 21.5 % overall, and 44.2 % and 14.8 % among patients
with macroscopic and microscopic haematuria, respectively. Univariate regression showed that the odds of
malignancy was signifi cantly higher among patients with antiplatelet therapy compared to patients without
antiplatelet therapy (OR: 1.88, 95% CI: 1.14‒3.05). In contrast, anticoagulation therapy did not signifi cantly
increase the odds of malignancy compared to no anticoagulation therapy (OR: 1.45, 95% CI: 0.74‒2.69).
However, a multiple logistic regression model that included other known risk factors (e.g., sex or age) showed
similar odds of malignancy among these patient groups.
CONCLUSIONS: Malignancy risk for patients who received anticoagulant or antiplatelet therapy was similar
to the risk observed in the general population. Antiplatelet and anticoagulant therapy were not signifi cant risk
factors of urological malignancy in patients with haematuria. The results from the present study will be used
in a power analysis for an upcoming multicentre study (Tab. 4, Ref. 17).Web of Science1241074173