VI-RADS in bladder cancer: Overview, pearls and pitfalls

Multiparametric magnetic resonance imaging (mpMRI) of the urinary bladder has shown high diagnostic per-formance in accurate staging of bladder cancer. Vesical Imaging Reporting and Data System (VI-RADS) scoring was developed in 2018 to standardize imaging and reporting of bladder cancer on mpMRI and is an excellent tool in preoperative T-staging of patients with high risk bladder cancer. However, there is no concise guide in the literature for practical use of VI-RADS in everyday clinical reporting. In this review, we describe our experience with mpMRI in pretreatment workup of bladder cancer, illustrate the imaging characteristics of VI-RADS cate-gories 1 to 5 using case review, and discuss practical pearls and pitfalls in the use of mpMRI and VI-RADS in the hope of providing an accessible reference for radiologists in daily reporting.

Automated summary

Multiparametric magnetic resonance imaging (mpMRI) has high diagnostic performance in accurate staging of bladder cancer. The Vesical Imaging Reporting and Data System (VI-RADS) scoring is an excellent tool in preoperative T-staging of high risk bladder cancer patients. However, there is currently no concise guide in the literature for the practical use of VI-RADS in everyday clinical reporting. This review aims to provide a reference for radiologists by sharing our experience with mpMRI in pretreatment workup of bladder cancer, illustrating the imaging characteristics of VI-RADS categories 1 to 5 using case review, and discussing practical pearls and pitfalls in the use of mpMRI and VI-RADS.