PriMera Scientific Surgical Research and Practice (ISSN: 2836-0028)

Research Article

Volume 6 Issue 3

Application of the VI-RADS Protocol in Urology for the Diagnosis and Treatment Planning of Bladder Cancer

Darenkov SP, Pronkin EA* and Musaev IE

August 29, 2025

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Abstract

Background: Bladder cancer is one of the most common malignancies of the urinary tract, ranking tenth in terms of global cancer prevalence. Accurate diagnosis and staging are critical for determining the optimal treatment strategy. Magnetic resonance imaging (MRI) has become a key diagnostic tool, and the Vesical Imaging-Reporting and Data System (VI-RADS) was introduced to standardize MRI interpretation and improve diagnostic accuracy.

Objective: This study aims to evaluate the effectiveness of the VI-RADS scale in distinguishing between muscle-invasive and non-muscle-invasive bladder cancer and to explore opportunities for refining MRI protocols by incorporating advanced imaging techniques.

Methods: A prospective study was conducted from 2023 to 2024 at the Federal Research and Clinical Center of the FMBA of Russia, involving 68 patients with suspected bladder cancer. All patients underwent pelvic MRI followed by en bloc transurethral resection (TUR) of the bladder. VI-RADS scores were assigned based on MRI findings, and results were compared with histological examination. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the performance of VI-RADS.

Results: Non-muscle-invasive bladder cancer was confirmed in 42 out of 50 patients (84%) in the low-risk VI-RADS group (1-3), while muscle invasion was detected in 14 out of 18 patients (77.8%) in the high-risk group (4-5). The VI-RADS system demonstrated a sensitivity of 63.6%, specificity of 91.3%, PPV of 77.8%, and NPV of 84%, with an overall accuracy of 80.9%. Advanced imaging techniques, such as ultrafast dynamic contrast-enhanced MRI, improved diagnostic precision by reducing false-positive and false-negative results.

Conclusion: The VI-RADS system is a valuable tool for assessing bladder cancer invasion depth, with high specificity that aids in reducing unnecessary radical procedures. However, its moderate sensitivity underscores the need for a comprehensive diagnostic approach. The integration of next-generation imaging modalities and molecular markers may further enhance staging accuracy and optimize treatment strategies for bladder cancer patients.

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