Evaluation of Multi-parametric Magnetic Resonance Imaging in Identifying Muscle Invasionin Patients Undergoing Restage Transurethral Resection of bladder: A Cross-Sectional Study.

Bladder cancer is the tenth most common and the thirteenth most deadly cancer worldwide. Transurethral resection of bladder cancer is the primary treatment modality for urinary bladder masses. After the initial resection, most of the tumors are Ta-T1 stage with no muscle invasion seen in the histopathological examination. Although Non-muscle invasive bladder cancer (NMIBC) cases account for more than 70-80% of the cases, the prognosis

significantly varied when compared to muscle-invasive bladder cancer (MIBC). Thus, it is imperative to not miss muscle-invasive disease post initial TURBT. Around 45% of the initial resections don’t include muscle and it was known that 7-30% of the MIBC cases are wrongly understated as NMIBC. So, a second look repeated TURBT (re-TURBT) 2-6 weeks following the initial TURBT is considered as standard management.

Multiparametric magnetic resonance imaging (mp-MRI) for bladder cancer is increasingly being employed in assessing the bladder walls so as to identify muscle involvement preoperatively. Various prospective and retrospective studies have validated the Vesical Imaging Reporting and Data System (VI-RADS) score in assessing the muscle invasion in patients with bladder masses in preoperative setting but, due to the limited number of trials

and various methodological drawbacks in them, no concrete conclusions were drawn on incorporating mp-MRI in the standard treatment protocols. So we intend to perform the current study to establish the efficacy of the VIRADS scoring system in predicting muscle invasion in patients with bladder cancer.