Kufukihara et al [58] compared the diagnostic accuracy of VI-RADS scoring with cystoscopy and found that VI-RADS had superior performance in detecting detrusor muscle invasion, especially in tumors located at the bladder neck/trigone/dome/posterior and anterior wall, but inferior performance in detecting tumors located on the lateral wall or ureteral orifice. Makboul et al [59] evaluated the usefulness of multiparametric MRI in differentiating MIBC from NMIBC with the accuracy of the VI-RADS scoring system. They found that multiparametric MRI is a comprehensive and effective tool for determining muscle invasion in bladder cancer and that VI-RADS can accurately differentiate between MIBC and NMIBC. Hagen et al [60] assessed the clinical applicability of preoperative multiparametric MRI using the 5-point VI-RADS scoring system to stage bladder cancer and compared it to dual-phase CECT. Both CECT and multiparametric MRI correctly identified tumor stages as either MIBC or NMIBC, but T stages bordering the histopathologic limits of muscle invasiveness resulted in overestimation of muscle invasion in 43% of cases for the multiparametric MRI image data sets and underestimation of muscle invasion in up to 55.5% of cases for the CECT data. MRI has been found to be more accurate than CT in identifying and localizing lymph nodes in the pelvic region for patients with pelvic malignancies, especially for smaller lymph nodes ranging from 1 to 5 mm in size [11,12]. Although lymph node metastases are rare for patients with tumors <T3 stage, the incidence increases from 20% to 30% and from 50% to 60% for patients with deep muscle layer involvement (T2b) and extravesical invasion, respectively. Thoeny et al [12] conducted a study on both patients with bladder cancer and patients with prostate cancer, using a combination of DWI compared with morphologic criteria on T2-weighted imaging to detect groin malignant lymph nodes.
Pretreatment Staging of Urothelial Cancer. Kufukihara et al [58] compared the diagnostic accuracy of VI-RADS scoring with cystoscopy and found that VI-RADS had superior performance in detecting detrusor muscle invasion, especially in tumors located at the bladder neck/trigone/dome/posterior and anterior wall, but inferior performance in detecting tumors located on the lateral wall or ureteral orifice. Makboul et al [59] evaluated the usefulness of multiparametric MRI in differentiating MIBC from NMIBC with the accuracy of the VI-RADS scoring system. They found that multiparametric MRI is a comprehensive and effective tool for determining muscle invasion in bladder cancer and that VI-RADS can accurately differentiate between MIBC and NMIBC. Hagen et al [60] assessed the clinical applicability of preoperative multiparametric MRI using the 5-point VI-RADS scoring system to stage bladder cancer and compared it to dual-phase CECT. Both CECT and multiparametric MRI correctly identified tumor stages as either MIBC or NMIBC, but T stages bordering the histopathologic limits of muscle invasiveness resulted in overestimation of muscle invasion in 43% of cases for the multiparametric MRI image data sets and underestimation of muscle invasion in up to 55.5% of cases for the CECT data. MRI has been found to be more accurate than CT in identifying and localizing lymph nodes in the pelvic region for patients with pelvic malignancies, especially for smaller lymph nodes ranging from 1 to 5 mm in size [11,12]. Although lymph node metastases are rare for patients with tumors <T3 stage, the incidence increases from 20% to 30% and from 50% to 60% for patients with deep muscle layer involvement (T2b) and extravesical invasion, respectively. Thoeny et al [12] conducted a study on both patients with bladder cancer and patients with prostate cancer, using a combination of DWI compared with morphologic criteria on T2-weighted imaging to detect groin malignant lymph nodes.