POL Scientific / Bladder / Volume 12 / Issue 4 / DOI: 10.14440/bladder.0022
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REVIEW

Diagnostic accuracy of the Vesical Imaging Reporting and Data System for muscle-invasive bladder cancer and its role in reducing repeat transurethral resection of bladder tumor: A systematic review

Debanjan Nandi1 ,  Surya Kant Kumar2 ,  Arshad Hasan3 ,  Vinod Kumar4*
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1 Department of Radiology, All India Institute of Medical Sciences, Kalyani 741245, West Bengal, India
2 Department of Urology, Narayan Medical College and Hospital, Jamuhar 821305, Rohtas, India
3 Department of Urology, Patna Medical College and Hospital, Patna 800004, Bihar, India
4 Department of Urology, All India Institute of Medical Sciences, Kalyani 741245, West Bengal, India
Bladder 2025 , 12(4), e21200065; https://doi.org/10.14440/bladder.0022
Submitted: 31 March 2025 | Revised: 28 July 2025 | Accepted: 5 August 2025 | Published: 12 November 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Background: The Vesical Imaging Reporting and Data System (VI-RADS) has been introduced as a standardized tool for assessing multiparametric magnetic resonance imaging (MRI) in the pre-operative staging of bladder cancer. Objective: The present systematic review evaluates the efficacy of VI-RADS in diagnosing muscle-invasive bladder cancer (MIBC) compared with established diagnostic techniques. A systematic review was conducted according to PRISMA guidelines using PubMed, Scopus, and Web of Science. Studies assessing VI-RADS for MIBC diagnosis were included if they reported sensitivity, specificity, area under the curve, and comparisons with conventional approaches. Study characteristics, sample size, VI-RADS cutoff, diagnostic performance, and risk of bias were evaluated. Thirteen studies (sample sizes ranging from 18 to 340) demonstrated high diagnostic performance, with sensitivity ranging from 78% to 100%, specificity from 73% to 96%, and AUC from 0.86 to 0.96. VI-RADS outperformed standard assessment in reducing transurethral resection of bladder tumor (TURBT)-related understaging. A forest plot showed variability in sensitivity, influenced by radiologist experience, magnetic resonance imaging protocols, and study design. The risk of bias was moderate-to-low. Conclusion: VI-RADS is an effective non-invasive tool for detecting MIBC and plays an important role in pre-operative decision-making. It may reduce the need for repeat TURBT. Standardization of MRI protocols and radiologist training is vital to improve diagnostic reliability.

Keywords
VI-RADS
Bladder cancer
Muscle-invasive bladder cancer
Multiparametric magnetic resonance imaging
Transurethral resection of bladder tumor
Diagnostic accuracy
Specificity
Funding
None.
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Conflict of interest
The authors declare that there is no conflict of interest.
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Bladder, Electronic ISSN: 2327-2120 Print ISSN: TBA, Published by POL Scientific
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