Diagnostic Accuracy of VI-RADS Using 3T Multiparametric MRI for Detection of Muscle Invasion and Its Potential Role in Treatment Planning in Bladder Cancer.

Authors

• Noor Atef Elhelow, Radiology department, Urology and Nephrology Center, Mansoura University, Mansoura, EgyptFollow
• Amina Ahmed Sultan, Radiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
• Tarek Mohsen, Radiology department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
• Mostafa Elmansy, Radiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Subject Area

Radiodiagnosis

Article Type

Original Study

Abstract

Background: Differentiating muscle-invasive bladder cancer (MIBC) from non-muscle-invasive bladder cancer (NMIBC) is crucial for management plan.

Aim of the work: to evaluate the diagnostic performance of Vesical Imaging Reporting and Data System (VI-RADS) in an Egyptian cohort using a 3 Tesla Multiparametric Magnetic Resonance Imaging (mpMRI) protocol and to explore its potential role in treatment planning.

Subjects and methods: Our prospective study enrolled 84 patients with bladder cancer, including 81 men and 3 women, over the period from October 2024 to September 2025. All participants underwent mpMRI on a 3 Tesla scanner using a protocol that included high-resolution T2-weighted imaging in the axial, coronal, and sagittal planes, diffusion-weighted imaging (DWI) with Apparent Diffusion Coefficient (ADC) mapping, and dynamic contrast-enhanced (DCE)T1-weighted sequences obtained with and without fat suppression. Demographic data were collected, VI-RADS was assigned, and its findings were correlated with cystoscopic and histopathological results, then receiver operating characteristic (ROC) curve analysis was performed.

Results: The diagnostic performance of VI-RADS in identifying muscle invasion was strong, particularly at a threshold of VI-RADS 3, where it achieved 100% sensitivity and 82.61% specificity. At a threshold of VI-RADS 4, sensitivity was 89.47% and specificity 86.96%, with positive predictive value (PPV) of 85%, negative predictive value (NPV) of 90.91%, Area Under the Curve (AUC) of 0.936, and an overall accuracy of 88.1%.

Conclusion: VI-RADS assessment using multiparametric MRI techniques is a reliable method for evaluating detrusor muscle invasion in bladder cancer patients with high diagnostic accuracy and may assist clinicians in treatment planning.

Recommended Citation

Elhelow, Noor Atef; Sultan, Amina Ahmed; Mohsen, Tarek; and Elmansy, Mostafa (2026) "Diagnostic Accuracy of VI-RADS Using 3T Multiparametric MRI for Detection of Muscle Invasion and Its Potential Role in Treatment Planning in Bladder Cancer.," Mansoura Medical Journal: Vol. 56 : Iss. 3 , Article 2.
Available at: https://doi.org/10.58775/2735-3990.1601

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