Conventional and innovative imaging modalities in Bladder Cancer: techniques and applications

This narrative review aims to describe the current status of imaging in the evaluation of Bladder Cancer, considering conventional technologies such as Ultrasound, Computed Tomography Urography, and Magnetic Resonance Imaging as well as novel technologies such as Contrast-Enhanced Ultrasound and Dual Energy Computed Tomography. The article is organized by first presenting an introduction to both the anatomy of the bladder in order to understand the normal appearance on imaging, and both the main features of bladder cancer with a reference to epidemiology, clinic, classification, and treatment. Subsequently, the role of imaging is discussed with an explanation of the technique and the applications in Bladder Cancer assessment for each modality. Imaging plays a critical role in the detection and staging of Bladder Cancer. In particular, MRI is acquiring an increasing role, since it makes it possible to distinguish between MIBC and NMIBC using the VI-RADS score system, at the side of conventional technologies like CTU and the US. To ensure the right approach to the oncological patient CEUS and DECT represent emerging modalities with specific advantages.