The Vesical Imaging-Reporting and Data System (VI-RADS) scoring system was elaborated in 2018 to standardize MRI acquisition and reporting for bladder cancer (BC) staging [1]. The aim of this educational review is to illustrate standard MRI protocols and reporting criteria for BC based on the VI-RADS and to discuss the role of imaging in post-treatment follow-up.

Bladder cancer (BC) represents a widespread and potentially life-threatening disease. Pathological and radiological diagnosis and evaluation are essential for management and treatment of bladder cancer. mpMRI allows to reduce staging errors compared to CT-urography, especially when pathologists disagree in BC staging or if radiologists have a different opinion about muscle invasion [2-3]. VI-RADS score is an imaging tool that can help urologists to differentiate patients with superficial or muscle-invasive disease before TURBT. MRI has proved to be an accurate, fast and non-invasive staging technique to...

MRI protocol Timing - 2 weeks after TURBT, bladder biopsy, or intravesical treatment [5]; - 2-3 day after cystoscopy or removal of Foley catheter [6]. Patient preparation -intramuscular spasmodic agents to avoid motion artifacts; -500-1000 ml of water per os within 30 min before examination to distend the bladder properly and to allow the visualization of all the layers of its wall [7-9]. Technical considerations - 1.5 or 3.0 T MRI and multichannel phased array external surface coil are recommended [6]. Image acquisition T2-weighted (T2W)...

MRI represents a promising tool to improve detection and preoperative staging of BC. It may facilitate patient care and VI-RADS most likely creates the premises for standardized staging before and after therapy of BC on mpMRI.

A. Pavone; Palermo/IT - nothing to disclose F. Vernuccio; Palermo/IT - nothing to disclose R. Cannella; Palermo/IT - nothing to disclose C. Leto; Palermo/IT - nothing to disclose M. Midiri; Palermo/IT - nothing to disclose G. Salvaggio; Palermo/IT - nothing to disclose M. Ferraro; Palermo/IT - nothing to disclose

[1] Wang et al. Multiparametric MRI for Bladder Cancer: Validation of VI-RADS for the Detection of Detrusor Muscle Invasion. Radiology 2019;291:668-674. [2] Soukup et al. Prognostic performance and reproducibility of the 1973 and 2004/2016 World Health Organization grading classification systems in non-muscle-invasive bladder cancer: a European Association of Urology Non-muscle Invasive Bladder Cancer Guidelines Panel systematic review. Eur Urol 2017;72:801–13. [3] Tritschler S et al. Staging of muscle-invasive bladder cancer: can computerized tomography help us to decide on local treatment? World J Urol 2012;30:827–31. [4]...