Clinical application of bladder MRI and the Vesical Imaging-Reporting And Data System

Diagnostic work-up and risk stratification in patients with bladder cancer before and after treatment must be refined to optimize management and improve outcomes. MRI has been suggested as a non-invasive technique for bladder cancer staging and assessment of response to systemic therapy. The Vesical Imaging-Reporting And Data System (VI-RADS) was developed to standardize bladder MRI image acquisition, interpretation and reporting and enables accurate prediction of muscle-wall invasion of bladder cancer. MRI is available in many centres but is not yet recommended as a first-line test for bladder cancer owing to a lack of high-quality evidence. Consensus-based evidence on the use of MRI-VI-RADS for bladder cancer care is needed to serve as a benchmark for formulating guidelines and research agendas until further evidence from randomized trials becomes available. MRI and the Vesical Imaging-Reporting And Data System are highly accurate imaging tools for bladder cancer staging. A panel of experts have agreed on their efficacy in different clinical settings for cancer care, using the Delphi methodology. This Expert Recommendation will provide guidance for future research agendas.

Automated summary

The diagnostic work-up and risk stratification in bladder cancer patients are important for optimizing management and improving outcomes. MRI has been suggested as a non-invasive technique for staging and assessing response to therapy. The Vesical Imaging-Reporting And Data System (VI-RADS) has been developed to standardize MRI image acquisition and interpretation for accurate prediction of muscle-wall invasion. However, more high-quality evidence is needed before MRI can be recommended as a first-line test for bladder cancer.