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VI-RADS Score Performance in the Post-TURBT Setting: Exploring the Need for Modification
Ailin Dehghanpour1, Martina Pecoraro2, Gu-Mu-Yang Zhang3
1Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy; Department of Experimental Medicine, Sapienza University of Rome, Italy.
European Urology Oncology
|July 17, 2026
Summary
Bladder MRI after TURBT is accurate when timing and image quality are optimized. Diffusion-weighted imaging (DWI)-dominant VI-RADS offers higher accuracy, especially when performed 2-4 weeks post-procedure.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- The Vesical Imaging-Reporting and Data System (VI-RADS) standardizes bladder MRI interpretation for treatment-naïve patients.
- Post-transurethral resection of bladder tumor (TURBT) changes can reduce diagnostic accuracy of bladder MRI.
- Optimal MRI timing and sequence selection are crucial for accurate post-TURBT assessment.
Purpose of the Study:
- To identify the optimal MRI sequence for VI-RADS scoring after TURBT.
- To determine the ideal timing for post-TURBT bladder MRI.
- To evaluate the impact of image quality on VI-RADS accuracy.
Main Methods:
- Retrospective single-center study of 123 bladder cancer patients undergoing TURBT followed by MRI.
- Radiologists assigned standard, DWI-dominant, and DCE-dominant VI-RADS scores.
- Diagnostic performance analyzed using ROC curves, stratified by time interval and image quality.
Main Results:
- DWI-dominant VI-RADS demonstrated higher diagnostic accuracy (86%-96%) compared to standard/DCE-dominant (77%).
- Optimal diagnostic accuracy was achieved 2-4 weeks after TURBT (94%-98%).
- Image quality significantly impacted diagnostic accuracy, with higher scores correlating with better results.
Conclusions:
- Bladder MRI remains accurate post-TURBT with careful consideration of timing, sequence weighting, and image quality.
- DWI-dominant VI-RADS shows superior diagnostic performance.
- Scheduling MRI 2-4 weeks post-TURBT and ensuring high image quality enhance diagnostic reliability.
