Diagnostic Accuracy of VI-RADS Scoring in Follow up of Bladder Cancer: A Prospective Study

Background: Determining the best course of treatment for bladder cancer (BC) requires accurate staging. Multiparametric magnetic resonance imaging's (mpMRI) potential is highlighted by recent developments in imaging technologies. Objective: In comparison to traditional cystoscopy and histological inspection during the follow-up of BC, this study sought to evaluate the diagnostic accuracy of mpMRI in identifying the existence of bladder mass and distinguishing between muscle-invasive (MIBC) and non-muscle-invasive bladder cancer (NMIBC). Thus, the viability of employing mpMRI as a BC follow-up modality was investigated, as it may lengthen the time between follow-up cystoscopies. Patients and Methods: This prospective study included 88 known BC patients. Eligible patients underwent history-taking, physical examinations, radiology, and laboratory tests. Patients with various contraindications were excluded. Preoperative mpMRI was performed, followed by diagnostic cystoscopy and transurethral resection of bladder tumor (TURBT) with histopathological examination. Results: The study included 88 patients (93.2% male) with a mean age of 64.1 years. The mpMRI Vesical Imaging-Reporting and Data System (VI-RADS) scoring showed high diagnostic performance in detecting presence of BC with an area under the curve (AUC) of 95%, 100% sensitivity, and 100% specificity. For muscle invasion detection during routine follow-up of BC patients, mpMRI VI-RADS scoring had an AUC of 95%, 100% sensitivity, and 90% specificity. Conclusion: mpMRI could be a less invasive alternative to cystoscopy when no bladder mass is present, thereby enhancing patient care and reducing the risks associated with invasive procedures.