Multiparametric Magnetic Resonance Imaging for Bladder Cancer: Development of VI-RADS (Vesical Imaging-Reporting And Data System)
Valeria Panebianco, Yoshifumi Narumi, Ersan Altun, Bernard H Bochner, Jason A Efstathiou, Shaista Hafeez, Robert Huddart, Steve Kennish, Seth Lerner, Rodolfo Montironi, Valdair F Muglia, Georg Salomon, Stephen Thomas, Hebert Alberto Vargas, J Alfred Witjes, Mitsuru Takeuchi, Jelle Barentsz, James W F Catto, Valeria Panebianco, Yoshifumi Narumi, Ersan Altun, Bernard H Bochner, Jason A Efstathiou, Shaista Hafeez, Robert Huddart, Steve Kennish, Seth Lerner, Rodolfo Montironi, Valdair F Muglia, Georg Salomon, Stephen Thomas, Hebert Alberto Vargas, J Alfred Witjes, Mitsuru Takeuchi, Jelle Barentsz, James W F Catto
Abstract
Context: Management of bladder cancer (BC) is primarily driven by stage, grade, and biological potential. Knowledge of each is derived using clinical, histopathological, and radiological investigations. This multimodal approach reduces the risk of error from one particular test, but may present a staging dilemma when results conflict. Multiparametric magnetic resonance imaging (mpMRI) may improve patient care through imaging of the bladder with better resolution of the tissue planes than computed tomography and without radiation exposure.
Objective: To define a standardized approach to imaging and reporting mpMRI for BC, by developing a VI-RADS score.
Evidence acquisition: We created VI-RADS (Vesical Imaging-Reporting And Data System) through consensus using existing literature.
Evidence synthesis: We describe standard imaging protocols and reporting criteria (including size, location, multiplicity, and morphology) for bladder mpMRI. We propose a five-point VI-RADS score, derived using T2-weighted MRI, diffusion-weighted imaging, and dynamic contrast enhancement, which suggests the risks of muscle invasion. We include sample images used to understand VI-RADS.
Conclusions: We hope that VI-RADS will standardize reporting, facilitate comparisons between patients, and in future years, will be tested and refined if necessary. While we do not advocate mpMRI for all patients with BC, this imaging may compliment pathology or reduce radiation-based imaging. Bladder mpMRI may be most useful in patients with non-muscle-invasive cancers, in expediting radical treatment or for determining response to bladder-sparing approaches.
Patient summary: Magnetic resonance imaging (MRI) scans for bladder cancer are becoming more common and may provide accurate information that helps improve patient care. Here, we describe a standardized reporting criterion for bladder MRI. This should improve communication between doctors and allow better comparisons between patients.
Keywords: Bladder cancer; Multiparametric magnetic resonance imaging; RADS; Scoring; Staging.
Conflict of interest statement
Financial disclosures: Valeria Panebianco certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: None.
Copyright © 2018 European Association of Urology. All rights reserved.
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Source: PubMed