Diagnostic Performance of Multiparametric Magnetic Resonance Imaging After Transurethral Resection of Bladder Tumour for Prediction of Muscle Invasion and Detection of Residual Tumour in Non-muscle-invasive Bladder Cancer Patients (SMART-BC)

November 4, 2026 updated by: Naik Vietti Violi, University of Lausanne Hospitals

SMART-BC is a prospective, single-centre clinical investigation evaluating the diagnostic performance of multiparametric magnetic resonance imaging (mpMRI) for detecting residual bladder tumour and predicting muscle invasion in patients with non-muscle-invasive bladder cancer (NMIBC).

The study comprises two work packages. WP1 will include 20 healthy volunteers to optimize the bladder MRI protocol using additional clinical sequences without contrast injection, assessing image quality through quantitative and qualitative metrics. WP2 will enrol up to 66 patients with newly diagnosed bladder lesions and suspicious or high-grade urinary cytology, aiming to obtain 33 evaluable patients who undergo pre- and post-transurethral resection of bladder tumour (TURBT) MRI and repeat TURBT (re-TURBT), when clinically indicated.

In WP2, mpMRI will be performed before initial TURBT and approximately 3-4 weeks afterwards in patients requiring re-TURBT. Diagnostic performance will be assessed using sensitivity, specificity, positive predictive value and negative predictive value, with histopathology as the reference standard. Standard VI-RADS sequences will be compared with an optimized protocol incorporating additional sequences. Secondary objectives include inter-reader agreement, patient-reported comfort and satisfaction, and preliminary evaluation of healthcare costs and the potential to avoid unnecessary re-TURBT procedures. Safety will be assessed through the systematic collection of adverse events, serious adverse events and device deficiencies.

The investigation uses CE-marked 3T MRI systems and follows routine clinical management pathways. Its long-term aim is to determine whether post-TURBT mpMRI can improve diagnostic assessment and support more personalized management of patients with high-risk NMIBC.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

86

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • All adult patients with bladder lesion at cystoscopy and indication for a TURBT, and with a urinary cytology positive or suspicious for atypia or high grade (HG) urothelial carcinoma .
  • Informed Consent signed by the subject

Exclusion Criteria:

  • Cystoscopic assessment suspicious for MIBC, or prior cross-sectional imaging-such as CT-demonstrating extra bladder extension (e.g., cT3-T4)
  • Pregnancy
  • MRI contrast agent precaution
  • MRI contraindication (including severe claustrophobia and metallic material presence)
  • Patients with hip prosthesis (to avoid non diagnostic MRI examination due to metal artifacts)
  • Any other condition making the patient unsuitable for the study
  • Patient's refusal of transmission of relevant medical conditions found on the medical examinations performed during the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Multiparametric Magnetic Resonance Imaging

Participants with suspected bladder cancer will undergo multiparametric magnetic resonance imaging before transurethral resection of bladder tumour. Patients requiring repeat resection according to clinical indications will undergo a second magnetic resonance imaging examination approximately 3-4 weeks after the initial resection. Imaging findings will be compared with histopathological results to assess diagnostic performance.

Bladder magnetic resonance imaging performed using a 3T MRI system, including standard VI-RADS sequences and additional optimized sequences. Imaging is performed before initial transurethral resection and, when clinically indicated, before repeat resection. The study evaluates image quality and the diagnostic performance of magnetic resonance imaging for detecting residual bladder tumour and predicting muscle invasion.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Diagnostic Performance
Time Frame: Approximately 3-4 weeks after initial transurethral resection, before repeat resection when clinically indicated.

Diagnostic accuracy metrics (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) of mpMRI performed 3-4 weeks after initial TURBT for detecting residual bladder tumour, using histopathology as the reference standard.

Approximately 3-4 weeks after initial transurethral resection, before repeat resection when clinically indicated.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

December 1, 2026

Primary Completion (Estimated)

March 3, 2028

Study Completion (Estimated)

March 31, 2028

Study Registration Dates

First Submitted

October 29, 2026

First Submitted That Met QC Criteria

November 4, 2026

First Posted (Actual)

November 9, 2026

Study Record Updates

Last Update Posted (Actual)

November 9, 2026

Last Update Submitted That Met QC Criteria

November 4, 2026

Last Verified

October 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.