{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T06:14:43Z","timestamp":1776320083128,"version":"3.50.1"},"reference-count":37,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T00:00:00Z","timestamp":1749168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T00:00:00Z","timestamp":1749168000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Urol Int"],"abstract":"<jats:p>Introduction: Although cystoscopy is highly accurate in managing bladder cancer, its invasive nature and high cost underscore the need for more practical, noninvasive alternatives. Urinary Twist Family BHLH Transcription Factor 1 (Twist1) methylation, an emerging biomarker, shows great promise for early diagnosis and postsurgical monitoring. Meanwhile, the Vesical Imaging-Reporting and Data System (VI-RADS), which incorporates multiple sequences of multiparametric MRI, demonstrates excellent diagnostic performance for bladder cancer. These tools could potentially overcome the limitations in managing non-muscle invasive bladder cancer (NMIBC), particularly in predicting residual tumor burden before repeat transurethral resection of bladder tumor (re-TURBT). This study aims to evaluate a predictive model that combines VI-RADS, urinary Twist1 methylation, and hematuria to guide clinical decision-making in NMIBC management. Methods: A prospective cohort study was conducted, including NMIBC patients who underwent re-TURBT at the Department of Urology, Zhongshan city People\u2019s Hospital, from June 2022 to May 2024. Morning urine samples were collected prior to re-TURBT to detect urinary Twist1 methylation, and a 3.0T MRI scan of the bladder was performed for VI-RADS scoring. Based on postoperative pathology results, patients were divided into residual tumor and non-residual tumor groups. Binary logistic regression was employed to identify independent predictors of residual tumor burden prior to re-TURBT. Two predictive models were subsequently developed. The diagnostic performance and clinical utility of these models were assessed using the receiver operating characteristic (ROC) curve and decision curve analysis (DCA). Results: The study ultimately included 52 patients who were initially diagnosed with NMIBC based on pathology. According to the pathological results after re-TURBT, the patients were divided into two groups: the tumor residue group (n = 22) and the control group (n = 30). Binary logistic regression analysis identified the VI-RADS score and urinary Twist1 methylation as independent predictors of residual tumor burden in NMIBC patients prior to re-TURBT. A predictive model incorporating these factors, along with the presence of visible hematuria within 1 week before re-TURBT, achieved a sensitivity of 95.45% and a specificity of 83.33% for diagnosing residual tumor burden. ROC curve analysis demonstrated an area under the curve (AUC) of 0.950 (95% CI: 0.884\u20131.000, p &lt; 0.001). DCA revealed that the model provided a net benefit for threshold probabilities ranging from 0.10 to 0.92. Conclusion: The predictive model combining VI-RADS score, urinary Twist1 methylation, and visible hematuria exhibits excellent diagnostic performance for predicting residual tumor burden in NMIBC patients, offering significant guidance for clinical practice.<\/jats:p>","DOI":"10.1159\/000546718","type":"journal-article","created":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T12:02:15Z","timestamp":1749211335000},"page":"114-124","source":"Crossref","is-referenced-by-count":1,"title":["The Predictive Value of Urinary Twist1 Methylation and VI-RADS Score for Residual Tumor before Repeat Transurethral Resection of Bladder Tumor in NMIBC Patients"],"prefix":"10.1159","volume":"110","author":[{"given":"Qi","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qisheng","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linfeng","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiyang","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaqiang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2025,6,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000002108"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-076743"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2018.02.014"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/BF03262330"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.08.010"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2023.08.002"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000100480.70769.0e"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.purol.2015.12.001"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-012-2387-0"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21327"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2017.5926"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2019182506"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2017171028"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2018.04.029"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-48840-9"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-024-05101-2"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.13182"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1089\/dna.2013.2030"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2009.07.041"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1002\/ctm2.1549"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.neo.2022.01.001"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkz830"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/s0090-4295(02)01920-9"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1089\/end.2011.0081"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2010.03.007"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1038\/s41388-021-02112-w"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-58586-7"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1038\/s41388-023-02936-8"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.cancergen.2021.12.001"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2015.04.014"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2021.103746"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-12110-2"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-42088-z"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1172\/JCI139597"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1080\/21681805.2021.1917652"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2023.07.002"}],"container-title":["Urologia Internationalis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000546718","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000546718","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:02:41Z","timestamp":1775145761000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000546718"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,6]]},"references-count":37,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,2]]},"published-print":{"date-parts":[[2026,4,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000546718","archive":["Portico"],"relation":{},"ISSN":["0042-1138","1423-0399"],"issn-type":[{"value":"0042-1138","type":"print"},{"value":"1423-0399","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,6]]}}}