Bladder cancer: MRI distinguishes muscle- vs non-muscle-invasive disease

  • Cornelissen SWE et al.
  • Urology
  • 25 Jul 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Multiparametric MRI shows high sensitivity and specificity for the differentiation between non-muscle invasive and muscle invasive bladder cancer.

Why this matters

  • Multiparametric MRI can be used to confirm suspected muscle invasive disease.
  • Prospective studies are needed to further evaluate primary tumor staging with multiparametric MRI.

Study design

  • Meta-analysis of 20 studies including 1724 patients with 1778 lesions.
  • Funding: None disclosed.

Key results

  • Overall accuracy of multiparametric MRI was 56.0% (95% CI, 49.6%-62.3%).
  • Pooled sensitivity and specificity for differentiating between stages ≤T1 and ≥T2 were 92% (95% CI, 88%-95%) and 88% (95% CI, 78%-94%).
  • Sensitivity and specificity for differentiating between stages ≤T2 and ≥T3 were 71% (95% CI, 59%-82%) and 77% (95% CI, 68%-84%).
  • Sensitivity and specificity (95% CIs), respectively, by stage:
    • Stage T1: 75% (47%-91%) and 95% (91%-97%).
    • Stage T2: 62% (49%-74%) and 66% (57%-75%).
    • Stage T3: 59% (43%-74%) and 80% (72%-86%).
    • Stage T4: 77% (55%-92%) and 97% (92%-99%).

Limitations

  • Heterogeneity among studies.
  • Small number of patients with stage ≥T2.