For the differentiation of NMIBC from MIBC, sensitivity ranges from 97% to 92% and specificity ranges from 79% to 88% [24-26]. Vesical Imaging-Reporting and Data System (VI-RADS) using multiparametric MRI with T2-weighted imaging, DWI and dynamic contrast-enhanced imaging has been developed to identify MIBC and standardize reporting. A multireader validation study of VI-RADS for the identification of MIBC demonstrated an intraclass correlation coefficient of 0.85 among 5 readers with a pooled area under the curve of 0.90 [27]. A larger study of 340 patients (255 with NMIBC and 85 with MIBC) concluded that VI-RADS had an accuracy of 94% for identifying MIBC among 2 readers [28]. Despite these results, there are limited data for use of MRI as a screening test in patients with previously treated bladder cancer. At this time, it is generally felt that urine cytological evaluation and conventional cystoscopy are sufficiently accurate for the diagnosis of bladder recurrence in this patient population. MRU MRU offers a comprehensive evaluation of the genitourinary tract and can be used to evaluate for metastatic disease and metachronous UTUC following treatment of NMIBC. In a study of 91 examinations in 88 patients with suspected UTUC, MRU had a sensitivity of 72.4% to 86.2% and specificity of 97.9% to 99.5% for 2 readers, respectively [40]. Radiography Chest Metastatic disease in patients with NMIBC is uncommon; however, chest radiography may be appropriate in patients with NMIBC with symptoms or risk factors. Radiography Intravenous Urography CTU and, to a lesser extent, MRU have replaced IVU for the evaluation of the upper urinary tract. IVU does not have a current role in surveillance of NMIBC. US Pelvis (Bladder) In a small prospective study, transabdominal US was found to have a sensitivity of 78.6% and specificity of 100% for the diagnosis of recurrent UC of the urinary bladder, with cystoscopy as the reference standard [32].
Post Treatment Surveillance of Bladder Cancer. For the differentiation of NMIBC from MIBC, sensitivity ranges from 97% to 92% and specificity ranges from 79% to 88% [24-26]. Vesical Imaging-Reporting and Data System (VI-RADS) using multiparametric MRI with T2-weighted imaging, DWI and dynamic contrast-enhanced imaging has been developed to identify MIBC and standardize reporting. A multireader validation study of VI-RADS for the identification of MIBC demonstrated an intraclass correlation coefficient of 0.85 among 5 readers with a pooled area under the curve of 0.90 [27]. A larger study of 340 patients (255 with NMIBC and 85 with MIBC) concluded that VI-RADS had an accuracy of 94% for identifying MIBC among 2 readers [28]. Despite these results, there are limited data for use of MRI as a screening test in patients with previously treated bladder cancer. At this time, it is generally felt that urine cytological evaluation and conventional cystoscopy are sufficiently accurate for the diagnosis of bladder recurrence in this patient population. MRU MRU offers a comprehensive evaluation of the genitourinary tract and can be used to evaluate for metastatic disease and metachronous UTUC following treatment of NMIBC. In a study of 91 examinations in 88 patients with suspected UTUC, MRU had a sensitivity of 72.4% to 86.2% and specificity of 97.9% to 99.5% for 2 readers, respectively [40]. Radiography Chest Metastatic disease in patients with NMIBC is uncommon; however, chest radiography may be appropriate in patients with NMIBC with symptoms or risk factors. Radiography Intravenous Urography CTU and, to a lesser extent, MRU have replaced IVU for the evaluation of the upper urinary tract. IVU does not have a current role in surveillance of NMIBC. US Pelvis (Bladder) In a small prospective study, transabdominal US was found to have a sensitivity of 78.6% and specificity of 100% for the diagnosis of recurrent UC of the urinary bladder, with cystoscopy as the reference standard [32].