Pictorial review of multiparametric MRI in bladder urothelial carcinoma with variant histology: Pearls and pitfalls Review
| Authors: | Arita, Y.; Woo, S.; Kwee, T. C.; Shigeta, K.; Ueda, R.; Nalavenkata, S.; Edo, H.; Miyai, K.; Das, J.; Andrieu, P. I. C.; Vargas, H. A. |
| Review Title: | Pictorial review of multiparametric MRI in bladder urothelial carcinoma with variant histology: Pearls and pitfalls |
| Abstract: | Bladder cancer (BC), predominantly comprising urothelial carcinomas (UCs), ranks as the tenth most common cancer worldwide. UCs with variant histology (variant UC), including squamous differentiation, glandular differentiation, plasmacytoid variant, micropapillary variant, sarcomatoid variant, and nested variant, accounting for 5–10% of cases, exhibit more aggressive and advanced tumor characteristics compared to pure UC. The Vesical Imaging-Reporting and Data System (VI-RADS), established in 2018, provides guidelines for the preoperative evaluation of muscle-invasive bladder cancer (MIBC) using multiparametric magnetic resonance imaging (mpMRI). This technique integrates T2-weighted imaging (T2WI), dynamic contrast-enhanced (DCE)-MRI, and diffusion-weighted imaging (DWI) to distinguish MIBC from non-muscle-invasive bladder cancer (NMIBC). VI-RADS has demonstrated high diagnostic performance in differentiating these two categories for pure UC. However, its accuracy in detecting muscle invasion in variant UCs is currently under investigation. These variant UCs are associated with a higher likelihood of disease recurrence and require precise preoperative assessment and immediate surgical intervention. This review highlights the potential value of mpMRI for different variant UCs and explores the clinical implications and prospects of VI-RADS in managing these patients, emphasizing the need for careful interpretation of mpMRI examinations including DCE-MRI, particularly given the heterogeneity and aggressive nature of variant UCs. Additionally, the review addresses the fundamental MRI reading procedures, discusses potential causes of diagnostic errors, and considers future directions in the use of artificial intelligence and radiomics to further optimize the bladder MRI protocol. Graphical abstract: (Figure presented.) © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024. |
| Keywords: | cancer patient; cancer staging; nuclear magnetic resonance imaging; magnetic resonance imaging; neoplasm staging; diagnostic accuracy; preoperative evaluation; diagnosis, differential; differential diagnosis; diffusion; pathology; diagnostic imaging; bladder cancer; bladder tumor; urinary bladder neoplasms; histology; artificial intelligence; urinary bladder; diagnostic error; contrast medium; contrast media; neoplasm invasiveness; anatomy; neoadjuvant chemotherapy; cancer classification; carcinoma, transitional cell; transitional cell carcinoma; radiodiagnosis; dynamic contrast-enhanced magnetic resonance imaging; diffusion weighted imaging; artifact reduction; bladder; diagnostic test accuracy study; bladder wall; muscle invasive bladder cancer; tumor invasion; procedures; workflow; non muscle invasive bladder cancer; spasmolytic agent; multiparametric magnetic resonance imaging; transurethral resection of the bladder; humans; human; article; radiomics; transurethral resection of bladder; diffusion kurtosis imaging; bladder distension; vesical imaging reporting and data system; t2 weighted imaging; dynamic contrast enhanced imaging; transitional cell carcinoma of the bladder |
| Journal Title: | Abdominal Radiology |
| Volume: | 49 |
| Issue: | 8 |
| ISSN: | 2366-004X |
| Publisher: | Springer |
| Date Published: | 2024-08-01 |
| Start Page: | 2797 |
| End Page: | 2811 |
| Language: | English |
| DOI: | 10.1007/s00261-024-04397-3 |
| PUBMED: | 38847848 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Yuki Arita -- Source: Scopus |
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