A Prospective Study on VI-RADS and Tumor Contact Length for Predicting Muscle-Invasive Bladder Cancer with MRI

Motivation: Accurately predicting muscle-invasive bladder cancer (MIBC) is crucial for guiding treatment, as non-invasive options are inadequate for aggressive cases. This prospective study aims to enhance diagnostic precision by incorporating tumor contact length (TCL) with VI-RADS scores. Goal(s): To evaluate if combining TCL measurements with VI-RADS improves the accuracy of MIBC predictions, ultimately supporting better clinical decision-making. Approach: 98 patients underwent multiparametric MRI, scored by radiologists using VI-RADS criteria, with additional TCL measurements. Inter-reader agreement and diagnostic accuracy were analyzed. Results: TCL addition improved diagnostic performance, demonstrating higher predictive accuracy for MIBC, with substantial inter-reader agreement supporting clinical reliability. Impact: Integrating TCL with VI-RADS enhances MIBC diagnostic accuracy, potentially influencing treatment strategies and improving patient outcomes. This study lays groundwork for further exploration of TCL's role in cancer imaging, paving the way for more precise and personalized bladder cancer care.