Moderate interobserver agreement was found for T and N staging, consistent with other studies [53,54]. Other studies demonstrated the sensitivity and specificity of MRI in distinguishing NMIBC from MIBC ranging from 78% to 98% and 82% to 100% and the sensitivity and specificity for distinguishing organ-confined from non-organ-confined bladder tumors ranging from 90% to 94% and 60% to 94%, respectively [51-54]. Multiparametric MRI, which combines dynamic contrast-enhanced imaging with DWI and T2-weighted imaging, is likely the most optimal MRI technique for local staging of bladder cancer [48,55]. MRU Without and With IV Contrast Abdominal MRI, specifically MRU, can be used to stage bladder cancer by evaluating nodal, upper tract, and metastatic involvement along with dedicated pelvic imaging to assess local staging. MRU is a viable alternative for CTU in the evaluation of upper tract disease. The main benefit of MRU over CTU is the inherent higher contrast resolution [62]. When the entire upper tract is not visualized or degraded by motion artifact, MRU sequences can be repeated multiple times without fear of added radiation risk. Inherent higher contrast resolution of MRU is particularly beneficial for small tumor detection. An MRU examination with and without IV contrast provides a more comprehensive evaluation than an MRU without IV contrast examination. MRU Without IV Contrast Noncontrast MRU is an option for assessing the renal collecting systems and ureters using a heavily T2-weighted sequence [63]. MRU may be performed for nodal, synchronous bladder, and metastatic staging. The main benefit of MRU over CTU is inherent higher contrast resolution [62]. When the entire upper tract is not visualized or degraded by motion artifact, MRU sequences can be repeated multiple times without fear of added radiation risk. Inherent higher contrast resolution of MRU is particularly beneficial for small tumor detection.
Pretreatment Staging of Urothelial Cancer. Moderate interobserver agreement was found for T and N staging, consistent with other studies [53,54]. Other studies demonstrated the sensitivity and specificity of MRI in distinguishing NMIBC from MIBC ranging from 78% to 98% and 82% to 100% and the sensitivity and specificity for distinguishing organ-confined from non-organ-confined bladder tumors ranging from 90% to 94% and 60% to 94%, respectively [51-54]. Multiparametric MRI, which combines dynamic contrast-enhanced imaging with DWI and T2-weighted imaging, is likely the most optimal MRI technique for local staging of bladder cancer [48,55]. MRU Without and With IV Contrast Abdominal MRI, specifically MRU, can be used to stage bladder cancer by evaluating nodal, upper tract, and metastatic involvement along with dedicated pelvic imaging to assess local staging. MRU is a viable alternative for CTU in the evaluation of upper tract disease. The main benefit of MRU over CTU is the inherent higher contrast resolution [62]. When the entire upper tract is not visualized or degraded by motion artifact, MRU sequences can be repeated multiple times without fear of added radiation risk. Inherent higher contrast resolution of MRU is particularly beneficial for small tumor detection. An MRU examination with and without IV contrast provides a more comprehensive evaluation than an MRU without IV contrast examination. MRU Without IV Contrast Noncontrast MRU is an option for assessing the renal collecting systems and ureters using a heavily T2-weighted sequence [63]. MRU may be performed for nodal, synchronous bladder, and metastatic staging. The main benefit of MRU over CTU is inherent higher contrast resolution [62]. When the entire upper tract is not visualized or degraded by motion artifact, MRU sequences can be repeated multiple times without fear of added radiation risk. Inherent higher contrast resolution of MRU is particularly beneficial for small tumor detection.