Management of bladder cancer (BC) is primarily driven by stage, grade, and biological potential. Knowledge of each is derived using clinical, histopathological, and radiological investigations. This multimodal approach reduces the risk of error from one particular test, but may present a staging dilemma when results conflict. Multiparametric magnetic resonance imaging (mpMRI) may improve patient care through imaging of the bladder with better resolution of the tissue planes than computed tomography and without radiation exposure.
To define a standardized approach to imaging and reporting mpMRI for BC, by developing a VI-RADS score.
We created VI-RADS (Vesical Imaging-Reporting And Data System) through consensus using existing literature.
We describe standard imaging protocols and reporting criteria (including size, location, multiplicity, and morphology) for bladder mpMRI. We propose a five-point VI-RADS score, derived using T2-weighted MRI, diffusion-weighted imaging, and dynamic contrast enhancement, which suggests the risks of muscle invasion. We include sample images used to understand VI-RADS.
We hope that VI-RADS will standardize reporting, facilitate comparisons between patients, and in future years, will be tested and refined if necessary. While we do not advocate mpMRI for all patients with BC, this imaging may compliment pathology or reduce radiation-based imaging. Bladder mpMRI may be most useful in patients with non-muscle-invasive cancers, in expediting radical treatment or for determining response to bladder-sparing approaches.
Magnetic resonance imaging (MRI) scans for bladder cancer are becoming more common and may provide accurate information that helps improve patient care. Here, we describe a standardized reporting criterion for bladder MRI. This should improve communication between doctors and allow better comparisons between patients.
European urology. 2018 May 10 [Epub]
Valeria Panebianco, Yoshifumi Narumi, Ersan Altun, Bernard H Bochner, Jason A Efstathiou, Shaista Hafeez, Robert Huddart, Steve Kennish, Seth Lerner, Rodolfo Montironi, Valdair F Muglia, Georg Salomon, Stephen Thomas, Hebert Alberto Vargas, J Alfred Witjes, Mitsuru Takeuchi, Jelle Barentsz, James W F Catto
Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Italy. Electronic address: ., Department of Radiology, Osaka Medical College, Takatsuki, Osaka, Japan., Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA., Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., The Institute of Cancer Research, Sutton, Surrey, UK; The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK., Department of Radiology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA., Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy., Imaging Division, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil., Martini Clinic, University Clinic Hamburg Eppendorf, Hamburg, Germany., Department of Radiology, University of Chicago, Chicago, IL, USA., Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA., Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands., Department of Radiology, Radiolonet Tokai, Nagoya, Japan., Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands., Academic Urology Unit, University of Sheffield, Sheffield, UK.