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)
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
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Naïk NVV Vietti-Violi, Médecin asscoiée
- Phone Number: +41 79 556 02 40
- Email: Naik.Vietti-Violi@chuv.ch
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
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
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / 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
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
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Urogenital Diseases
- Pathologic Processes
- Urogenital Neoplasms
- Neoplasms by Site
- Neoplasms
- Male Urogenital Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Neoplasms by Histologic Type
- Neoplasms, Glandular and Epithelial
- Neoplastic Processes
- Urologic Neoplasms
- Carcinoma
- Urinary Bladder Diseases
- Pathological Conditions, Signs and Symptoms
- Non-Muscle Invasive Bladder Neoplasms
- Neoplasm, Residual
- Urinary Bladder Neoplasms
Other Study ID Numbers
Other Study ID Numbers
- 2026-D0029
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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