Mesane tümörlerinde multiparametrik manyetik rezonans görüntülemesinde skorlama sisteminin (VIRADS) klinik tanı ve tedavi üzerine etkileri
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Mesane kanseri hastalarında tümörün lokal evrelendirmesi için preoperatif mpMRG (multiparametrik manyetik rezonans görüntüleme) yöntemi ile değerlendirmeyi ve histopatolojik sonuçlarla karşılaştırarak klinik etkinliğini göstermeyi amaçladık. Gereç ve Yöntem: Çalışmaya Kasım 2020 ile Nisan 2022 tarihleri arasında mesane tümörü ön tanısı ile sistoskopi planlanan ve daha önce mesane tümörü tanısı almış rezidü tümörü olan 63 hasta dahil edildi. Bu hastalar preoperatif mpMRG yöntemi ile T2 ağırlıklı (T2A) görüntüleme, difüzyon ağırlıklı görüntüleme (DAG), dinamik kontrastlı görüntüleme (DKG) sekansları birlikte değerlendirildi. Tüm MR görüntüleri 'Vesical Imaging Reporting And Data System' (VIRADS) kriterlerine göre incelendi. Tüm lezyonlar 5 kategoriden oluşan VIRADS skorlarına göre sınıflandırıldı. Daha sonra hastalardan alınan biyopsiler histopatolojik olarak incelendi ve radyolojik bulgularla karşılaştırıldı. Bulgular: Çalışmaya dahil edilen 63 hastanın 60'ı erkek, 3'ü kadın hasta ve yaş ortalaması 64,2±10,55 olarak hesaplandı. Hastaların 41'i primer mesane tümörü ve 22 hasta nüks mesane tümörü, rezidü tümörü olan ve/veya radikal sistektomi planlanan hasta grubunda yer aldı. VIRADS skoru >3 olan tümörler kasa invaze olarak gruplandırıldığında 63 hastanın 53'ü (%84) radyolojik olarak invaziv mesane tümörü olarak değerlendirildi. Fakat histopatolojik olarak 33 (%52,4) hastada invaziv mesane tümörü saptandı. Bu çalışmada duyarlılık %100, özgüllük %33, negatif öngörü değeri %100, pozitif öngörü değeri %62 olarak hesaplandı. Ayrıca bu çalışma sonucunda VIRADS skorunun kas invazyonunu saptamadaki öngörüsü ile tümör hacmi arasındaki korelasyonun anlamlı olmadığı saptandı (p değeri 0,529). Sonuç: Çalışmamızın sonuçlarına göre ameliyat öncesi mesane kanseri evrelemesi klinik tanı ve tedavi yaklaşımı açısından önemlidir. MpMRG kullanılarak elde edilen VIRADS skorlama sisteminin özellikle mesane kas invazyonu olmadığını saptamada başarılı bir yöntemdir. Mesane tümörlerinde kasa invazyonu saptamadaki başarısı daha fazla yapılacak çalışmalar ile tanısal verimliliğin artırılabileceği bir yöntemdir. Anahtar Kelimeler: Mesane kanseri, VIRADS, kas invazyonu
Objective: The aim of our study is to determine the local staging of the tumor in bladder cancer patients with preoperatively mpMRI (multiparametric magnetic resonance imaging) method and to show its clinical effectiveness by comparing it with histopathological results. Materials and Methods: Between November 2020 and April 2022, 63 patients who were planned cystoscopy with preliminary diagnosis of bladder cancer and previously diagnosed with bladder cancer included in the study. Preoperatively, these patients were evaluated together with T2-weighted (T2W) imaging, diffusion-weighted imaging (DAG), and dynamic contrast imaging (DKG) sequences with mpMRI method. All MRI images were examined according to the criteria of "Vesical Imaging Reporting and Data System" (VIRADS). All lesions were classified according to VIRADS scores consisting of 5 categories. Afterwards, biopsies obtained from the patients were examined histopathological and compared with radiological findings. Results: Of the 63 patients included in the study, 60 were (%95,2) male and 3 were (%4,8) female. The age of the patients ranged from 22 to 89 years, with a mean age of 64,2 years. 41 of the patients were included in the group of patients with primary bladder tumor and 22 patients with recurrent bladder tumor, residual tumor and/or who planned radical cystectomy. When tumors that VIRADS score >3 were grouped as muscle invasive, 53 patients (%84) were radiologically evaluated as invasive bladder tumor. However, according to the histopathological results, invasive bladder tumor was detected in 33 (52.4%) patients. In this study, sensitivity was calculated as 100%, specificity 33%, negative predictive value 100%, positive predictive value 62%. In addition, as a result in this study, it is concluded that there is not significant positive relationship between the prediction of the VIRADS score in detecting muscle invasion and tumor volume (p value 0,529). Conclusion: According to the results of our study, preoperatively, bladder cancer staging is important in terms of clinical diagnosis and treatment approach. The VIRADS scoring system obtained by using MpMRI is a successful method, especially in detecting non-muscle invasive bladder tumor, and also its successful in detecting muscle invasion is a method in which diagnostic efficiency can be increased with further studies. Key words: bladder cancer, VIRADS, muscle invasion
Objective: The aim of our study is to determine the local staging of the tumor in bladder cancer patients with preoperatively mpMRI (multiparametric magnetic resonance imaging) method and to show its clinical effectiveness by comparing it with histopathological results. Materials and Methods: Between November 2020 and April 2022, 63 patients who were planned cystoscopy with preliminary diagnosis of bladder cancer and previously diagnosed with bladder cancer included in the study. Preoperatively, these patients were evaluated together with T2-weighted (T2W) imaging, diffusion-weighted imaging (DAG), and dynamic contrast imaging (DKG) sequences with mpMRI method. All MRI images were examined according to the criteria of "Vesical Imaging Reporting and Data System" (VIRADS). All lesions were classified according to VIRADS scores consisting of 5 categories. Afterwards, biopsies obtained from the patients were examined histopathological and compared with radiological findings. Results: Of the 63 patients included in the study, 60 were (%95,2) male and 3 were (%4,8) female. The age of the patients ranged from 22 to 89 years, with a mean age of 64,2 years. 41 of the patients were included in the group of patients with primary bladder tumor and 22 patients with recurrent bladder tumor, residual tumor and/or who planned radical cystectomy. When tumors that VIRADS score >3 were grouped as muscle invasive, 53 patients (%84) were radiologically evaluated as invasive bladder tumor. However, according to the histopathological results, invasive bladder tumor was detected in 33 (52.4%) patients. In this study, sensitivity was calculated as 100%, specificity 33%, negative predictive value 100%, positive predictive value 62%. In addition, as a result in this study, it is concluded that there is not significant positive relationship between the prediction of the VIRADS score in detecting muscle invasion and tumor volume (p value 0,529). Conclusion: According to the results of our study, preoperatively, bladder cancer staging is important in terms of clinical diagnosis and treatment approach. The VIRADS scoring system obtained by using MpMRI is a successful method, especially in detecting non-muscle invasive bladder tumor, and also its successful in detecting muscle invasion is a method in which diagnostic efficiency can be increased with further studies. Key words: bladder cancer, VIRADS, muscle invasion
Açıklama
Anahtar Kelimeler
Üroloji, Urology
