Multiparametric magnetic resonance imaging (mpMRI) can differentiate between nonmuscle invasive and muscle-invasive bladder cancer with a high degree of accuracy, according to a new systematic review and meta-analysis.

Based on the finding, investigators recommend using mpMRI for diagnostic confirmation when stage T2 or higher tumors are suspected at the time of first tumor detection, according to a report published in Urology.

When the tumor is confirmed as stage T2 or higher, treatment could be started immediately rather than performing transurethral resection of bladder tumor (TUR-BT), Suzan Cornelissen, MSc, of Radboud University in Nijmegen, The Netherlands, and her colleagues concluded. “This will decrease time between diagnosis and definitive treatment,” they wrote. “Furthermore, this will reduce the risk of tumor-spill by bladder perforation after TUR-BT.”

In an analysis of data from 20 studies that included 1724 patients with 1778 lesions, Cornelissen’s team found that the pooled sensitivity and specificity for differentiating stages T1 or less from T2 or higher tumors were 92% and 88%, respectively. The sensitivity and specificity for differentiating stage T2 or less tumors from stage T3 or higher tumors were 71% and 77%, respectively. The sensitivity and specificity, respectively, were 75% and 95% for stage T1, 62% and 66% for stage T2, 59% and 80% for stage T3, and 77% and 97% for stage T4.


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Reference

Cornelissen SWE, Veenboer PW, Wessels FJ, et al. Diagnostic accuracy of multiparametric MRI for local staging of bladder cancer: A systematic review and meta-analysis. Urology. Published online July 25, 2020. doi:10.1016/j.urology.2020.07.021