[mpMRI of the Urinary Bladder: Significance and Clinical Use].

Abstract

The diagnosis and staging of bladder cancer is challenging. TUR-B and CT diagnostics bear limitations in detecting muscle invasion and perivesical fat invasion. Thus, second TUR-B is required to ensure more reliable pathological staging. The mpMRI of the urinary bladder is a new diagnostic tool in evaluation of tumor muscle invasion. Numerous retrospective and prospective studies indicate high diagnostic accuracy of the mpMRI in this setting. Current meta-analyses show sensitivities of up to 90% with a high specificity of >85%. The "Vesical Imaging-Reporting and Data System" (VI-RADS) is a standardized and clinically easy-to-use reporting system for mpMRI of the urinary bladder. The EAU guidelines recommend the mpMRI and the VI-RADS system for local staging of urinary bladder cancer. A recently published consensus statement based on a Delphi conference of 92 international experts favors the use of the mpMRI in various clinical situations. This includes imaging before and after TUR-B when muscle invasion is possible or during neoadjuvant chemotherapy.Based on good evidence, the mpMRI of the bladder emerges as a useful imaging tool in the evaluation of urinary bladder cancer in various clinical scenarios. Availability, costs and limited experience currently stand in the way of widespread use.