Clinical application of bladder MRI and the Vesical Imaging-Reporting And Data System

Diagnostic work-up and risk stratification in patients with bladder cancer before and after treatment must be refined to optimize management and improve outcomes. MRI has been suggested as a non-invasive technique for bladder cancer staging and assessment of response to systemic therapy. The Vesical Imaging-Reporting And Data System (VI-RADS) was developed to standardize bladder MRI image acquisition, interpretation and reporting and enables accurate prediction of muscle-wall invasion of bladder cancer. MRI is available in many centres but is not yet recommended as a first-line test for bladder cancer owing to a lack of high-quality evidence. Consensus-based evidence on the use of MRI-VI-RADS for bladder cancer care is needed to serve as a benchmark for formulating guidelines and research agendas until further evidence from randomized trials becomes available. MRI and the Vesical Imaging-Reporting And Data System are highly accurate imaging tools for bladder cancer staging. A panel of experts have agreed on their efficacy in different clinical settings for cancer care, using the Delphi methodology. This Expert Recommendation will provide guidance for future research agendas.