Learning objectives
To provide a comprehensive overview of the vesical imaging reporting and data system (VI-RADS).
To introduce its application in clinical practice, using a step-by-step approach, illustrated by multiple case examples.
Background
The prognosis and management of bladder cancer depends on tumour stage.
Bladder cancer staging is made by TNM classification. (Table 1).
More than 30% of bladder cancers are muscle invasive, needing a different therapeutic management.
Non-invasive cancer: transurethral resection (TUR) followed or not by intravesical chemotherapy or immunotherapy.
Muscle invasive: radical cystectomy followed by radiotherapy, chemotherapy, immunotherapy or a combination of them.
Clinical staging, based on cystoscopy and transurethral resection of bladder tumour (TURBT), is associated with 23 to 50% diagnostic inaccuracy.
Multiparametric MRI offers...
Findings and procedure details
MRI SEQUENCES
Examinations should be performed in 1.5 or 3 T MRI unit. The examination includes T2W, diffusion-weighted (DWI) and dynamic contraste enhanced (DCE) sequences.
At least 2 planes of multiplanar T2W turbo-spin-echo.
2 planes, including axial, of DWI sequences. High b value (800-1000) needed.
Pre-contrast image and DCE.
VI-RADS SCORE SYSTEM (Table 2).
The VI-RADS standardizes the interpretation and reporting of examinations based on multiparametric MRI. The score is based on these sequences:
T2-weighted for structural category (morphology of the tumour).
DWI and DCE...
Conclusion
The VI-RADS system helps to create a systematic approach to reporting bladder MRI findings as well as defining the risk of muscle invasion.
It is important for radiologists to use the VI-RADS system in daily practice to write clear and concise reports that improve communication with urologists.
Personal information and conflict of interest
E. Castro López; Corunna/ES - nothing to disclose C. Méndez Díaz; Corunna/ES - nothing to disclose R. Soler Fernandez; Corunna/ES - nothing to disclose E. Rodriguez Garcia; Corunna/ES - nothing to disclose S. Martinez Breijo; Corunna/ES - nothing to disclose D. Vázquez-Martul Pazos; Corunna/ES - nothing to disclose M. A. García Expósito; Corunna/ES - nothing to disclose
References
1.Barchetti G, Simone G, Ceravolo I, Salvo V, Campa R, Del Giudice F, De Berardinis E, Buccilli D, Catalano C, Gallucci M, Catto JWF, Panebianco V. Multiparametric MRI of the bladder: inter-observer agreement and accuracy with the Vesical Imaging-Reporting and Data System (VI-RADS) at a single reference center. Eur Radiol. 2019 Oct;29(10):5498-5506
2.Del Giudice F, Barchetti G, De Berardinis E, Pecoraro M, Salvo V, Simone G, Sciarra A, Leonardo C, Gallucci M, Catalano C, Catto JWF, Panebianco V. Prospective Assessment of Vesical Imaging Reporting and...
