Multiparametric MRI and artificial intelligence in predicting and monitoring treatment response in bladder cancer Review


Authors: Arita, Y.; Kwee, T. C.; Akin, O.; Shigeta, K.; Paudyal, R.; Roest, C.; Ueda, R.; Lema-Dopico, A.; Nalavenkata, S.; Ruby, L.; Nissan, N.; Edo, H.; Yoshida, S.; Shukla-Dave, A.; Schwartz, L. H.
Review Title: Multiparametric MRI and artificial intelligence in predicting and monitoring treatment response in bladder cancer
Abstract: Abstract: Bladder cancer is the 10th most common and 13th most deadly cancer worldwide, with urothelial carcinomas being the most common type. Distinguishing between non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) is essential due to significant differences in management and prognosis. MRI may play an important diagnostic role in this setting. The Vesical Imaging Reporting and Data System (VI-RADS), a multiparametric MRI (mpMRI)-based consensus reporting platform, allows for standardized preoperative muscle invasion assessment in BCa with proven diagnostic accuracy. However, post-treatment assessment using VI-RADS is challenging because of anatomical changes, especially in the interpretation of the muscle layer. MRI techniques that provide tumor tissue physiological information, including diffusion-weighted (DW)- and dynamic contrast-enhanced (DCE)-MRI, combined with derived quantitative imaging biomarkers (QIBs), may potentially overcome the limitations of BCa evaluation when predominantly focusing on anatomic changes at MRI, particularly in the therapy response setting. Delta-radiomics, which encompasses the assessment of changes (Δ) in image features extracted from mpMRI data, has the potential to monitor treatment response. In comparison to the current Response Evaluation Criteria in Solid Tumors (RECIST), QIBs and mpMRI-based radiomics, in combination with artificial intelligence (AI)-based image analysis, may potentially allow for earlier identification of therapy-induced tumor changes. This review provides an update on the potential of QIBs and mpMRI-based radiomics and discusses the future applications of AI in BCa management, particularly in assessing treatment response. Critical relevance statement: Incorporating mpMRI-based quantitative imaging biomarkers, radiomics, and artificial intelligence into bladder cancer management has the potential to enhance treatment response assessment and prognosis prediction. Key Points: Quantitative imaging biomarkers (QIBs) from mpMRI and radiomics can outperform RECIST for bladder cancer treatments. AI improves mpMRI segmentation and enhances radiomics feature extraction effectively. Predictive models integrate imaging biomarkers and clinical data using AI tools. Multicenter studies with strict criteria validate radiomics and QIBs clinically. Consistent mpMRI and AI applications need reliable validation in clinical practice. © The Author(s) 2024.
Keywords: controlled study; treatment response; overall survival; review; cisplatin; doxorubicin; fluorouracil; area under the curve; methotrexate; nuclear magnetic resonance imaging; diagnostic accuracy; biological marker; cancer immunotherapy; computer assisted tomography; image analysis; bladder cancer; prediction; vinblastine; biomarker; cancer specific survival; artificial intelligence; echography; contrast medium; cystoscopy; external beam radiotherapy; mitomycin; transitional cell carcinoma; dynamic contrast-enhanced magnetic resonance imaging; diffusion weighted imaging; chemoradiotherapy; urinary bladder neoplasm; diagnostic test accuracy study; muscle invasive bladder cancer; feature extraction; apparent diffusion coefficient; cancer prognosis; response evaluation criteria in solid tumors; multiparametric magnetic resonance imaging; transurethral resection of the bladder; human; disease assessment; radiomics; reporting and data system; t2 weighted imaging; methodological radiomics score
Journal Title: Insights into Imaging
Volume: 16
ISSN: 1869-4101
Publisher: SpringerOpen  
Date Published: 2025-01-02
Start Page: 7
Language: English
DOI: 10.1186/s13244-024-01884-5
PROVIDER: scopus
PMCID: PMC11695553
PUBMED: 39747744
DOI/URL:
Notes: Review -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Yuki Arita -- Source: Scopus
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MSK Authors
  1. Lawrence H Schwartz
    312 Schwartz
  2. Amita Dave
    140 Dave
  3. Oguz Akin
    271 Akin
  4. Ramesh Paudyal
    39 Paudyal
  5. Yuki Arita
    20 Arita
  6. Noam Nissan
    10 Nissan
  7. Lisa Ruby
    7 Ruby