• Valeria Panebianco, Yoshifumi Narumi, Ersan Altun, Bernard H Bochner, Jason A Efstathiou, Shaista Hafeez, Robert Huddart, Steve Kennish, Seth Lerner, Rodolfo Montironi, Valdair F Muglia, Georg Salomon, Stephen Thomas, Hebert Alberto Vargas, J Alfred Witjes, Mitsuru Takeuchi, Jelle Barentsz, and CattoJames W FJWFAcademic Urology Unit, University of Sheffield, Sheffield, UK..
• Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Italy. Electronic address: valeria.panebianco@uniroma1.it.
• Eur. Urol. 2018 Sep 1; 74 (3): 294-306.

ContextManagement of bladder cancer (BC) is primarily driven by stage, grade, and biological potential. Knowledge of each is derived using clinical, histopathological, and radiological investigations. This multimodal approach reduces the risk of error from one particular test, but may present a staging dilemma when results conflict. Multiparametric magnetic resonance imaging (mpMRI) may improve patient care through imaging of the bladder with better resolution of the tissue planes than computed tomography and without radiation exposure.ObjectiveTo define a standardized approach to imaging and reporting mpMRI for BC, by developing a VI-RADS score.Evidence AcquisitionWe created VI-RADS (Vesical Imaging-Reporting And Data System) through consensus using existing literature.Evidence SynthesisWe describe standard imaging protocols and reporting criteria (including size, location, multiplicity, and morphology) for bladder mpMRI. We propose a five-point VI-RADS score, derived using T2-weighted MRI, diffusion-weighted imaging, and dynamic contrast enhancement, which suggests the risks of muscle invasion. We include sample images used to understand VI-RADS.ConclusionsWe hope that VI-RADS will standardize reporting, facilitate comparisons between patients, and in future years, will be tested and refined if necessary. While we do not advocate mpMRI for all patients with BC, this imaging may compliment pathology or reduce radiation-based imaging. Bladder mpMRI may be most useful in patients with non-muscle-invasive cancers, in expediting radical treatment or for determining response to bladder-sparing approaches.Patient SummaryMagnetic resonance imaging (MRI) scans for bladder cancer are becoming more common and may provide accurate information that helps improve patient care. Here, we describe a standardized reporting criterion for bladder MRI. This should improve communication between doctors and allow better comparisons between patients.Copyright © 2018 European Association of Urology. All rights reserved.

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