MRI with VI-RADS for Bladder Cancer Staging

What is it about?

Bladder cancer (BCa) is a significant health burden due to its high prevalence, multifocality, and frequent recurrence. Accurate staging, especially distinguishing non-muscle-invasive bladder cancer (NMIBC) from muscle-invasive bladder cancer (MIBC), is crucial for guiding treatment decisions. A narrative review explores the potential implications of incorporating multiparametric magnetic resonance imaging (mpMRI) and the Vesical Imaging Reporting Data System (VI-RADS) into BCa staging, focusing on repeat transurethral resection of bladder tumour (re-TURBT). Six recent studies met inclusion criteria, with VI-RADS scoring accurately predicting muscle invasion, aiding in NMIBC/MIBC differentiation. VI-RADS scores of ≥3 indicated MIBC with high sensitivity and specificity. VI-RADS potentially identified patients benefiting from re-TURBT and those for whom it could be safely omitted. mpMRI and VI-RADS offer promising prospects for BCa staging, potentially correlating more closely with re-TURBT and radical cystectomy histopathology than initial TURBT. However, further research and validation are required to refine patient selection criteria and define the role of bladder mpMRI in clinical practice.

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Photo by Debby Hudson on Unsplash

Photo by Debby Hudson on Unsplash

Why is it important?

This research is important as it explores the potential implications of incorporating multiparametric magnetic resonance imaging (mpMRI) and the Vesical Imaging Reporting Data System (VI-RADS) into bladder cancer (BCa) staging, specifically focusing on repeat transurethral resection of bladder tumour (re-TURBT). Accurate staging is crucial for guiding treatment decisions and improving patient outcomes. The study identifies VI-RADS scoring as a valuable tool in identifying patients who may benefit from re-TURBT and those for whom it could be safely omitted, potentially leading to more efficient treatment strategies, reduced patient burden, and optimised healthcare resource allocation. Key Takeaways: 1. Multiple studies have shown VI-RADS to be closely aligned to re-resection or radical cystectomy pathology results, which could lead to more efficient treatment strategies, reduced patient burden, and optimised healthcare resource allocation. 2. VI-RADS scoring has the potential to significantly impact BCa management, particularly regarding re-TURBT. 3. VI-RADS scoring may serve as a valuable tool in identifying patients who may benefit from re-TURBT and those for whom re-TURBT could be safely omitted. 4. Further research and validation are required to refine patient selection criteria and define the role of bladder mpMRI in clinical practice.