VI-RADS (Vesical Imaging Reporting and Data System)

Bladder cancer treatment turns on stage, grade and above all on whether the tumour has invaded the muscle of the bladder wall. VI-RADS (Panebianco and colleagues, European Urology 2018) standardises multiparametric MRI of the bladder and proposes a five-point score, built from T2-weighted, diffusion-weighted and dynamic contrast images, for the risk of muscle invasion. The authors do not advocate MRI for everyone with bladder cancer; they see it as most useful in non-muscle-invasive disease, in speeding radical treatment, and in judging response to bladder-sparing treatment. The American College of Radiology now lists it among its RADS and runs a works-in-progress committee on its implementation.