Role Of Magnetic Resonance Imaging Research Articles

Role of magnetic resonance imaging in the evaluation of non-palpable breast masses

Background: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) provides anatomical and functional information with high sensitivity and variable specificity, making it a useful tool in the detection of breast cancer. The noninvasive functional imaging method known as diffusion-weighted imaging (DWI), sensitive to tissue microstructure and cellularity. The aim of this work was to assess the role of DCE-MRI and DWI in the evaluation of non-palpable breast masses. Methods: Fifty female cases participated in a prospective research who were suspected to have non-palpable breast masses accidentally discovered or suspected by ultrasound and referred to MR units. All cases were subjected to complete personal and medical history, full clinical examination, laboratory investigations, mammogram and breast ultrasound and breast MRI. Results: DCE-MRI could predict non-palpable malignant lumps with 89.66% sensitivity, 95.24% specificity, 96.30% (PPV), 86.96% (NPV) and 92% accuracy. MRI could predict non-palpable benign lumps with 90.48% sensitivity, 96.55% specificity, 95% (PPV), 93.33% (NPV) and 94% accuracy. DWI could predict malignant masses with 93.10% sensitivity, 71.43% specificity, 81.82% (PPV), 88.24% (NPV) and accuracy 84%.Conclusions: DCE-MRI outperformed DWI-MRI in diagnostic performance; however, DWI-MRI still demonstrated good diagnostic performance with a 93.1% sensitivity and specificity of 71.4%. Both are excellent non-invasive techniques that are very useful in assessing non-palpable breast masses.

Role of Magnetic Resonance Imaging in Velopharynageal Insufficiency Correction

Role of Magnetic Resonance Imaging in Velopharynageal Insufficiency Correction

The role of magnetic resonance imaging in the diff erential diagnosis of Parkinson’s disease

Parkinson’s disease (PD) is one of the most common neurodegenerative diseases in the world. While until recently MRI was used exclusively for the diagnosis of symptomatic forms of parkinsonism, recent advances in neuroimaging allow the detection of signs of nigral degeneration (MR biomarkers of PD). The article discusses the possibilities of modern MRI modes sensitive to iron (SWI, T2*) and neuromelanin (neuromelanin-sensitive MRI); emphasis is placed on identifying false-negative and false-positive results of the study. The imaging of nigrosome-1 in the dorsal substantia nigra (SN) in MRI-SWI has been discussed since 2013. In the absence of nigral degeneration, this area is defi ned as a hyperintense ovoid area within the dorsolateral border of the hypointense SN (“swallow’s tail” sign). If the optimistic results of the fi rst studies testifi ed to the high sensitivity and specifi city of this technique in PD (the absence of the “swallow’s tail” sign), then in subsequent studies, similar changes were detected in patients with other neurodegenerations with parkinsonism. In addition, the diagnostic value of this technique occurs when using tomographs with a magnetic fi eld strength of at least 3 Tc. Similar conclusions can be drawn about the use of neuromelanin-sensitive MRI, since it is necessary to use high-fi eld magnetic tomographs of 3 Tc or more to detect nigral degeneration, and results similar to PD can also be found in atypical forms of parkinsonism. However, the search for signs of nigral degeneration may be useful in the diff erential diagnosis of PD and non-neurodegenerative disorders. In addition to MRI in the diagnosis of PD, the article discusses neuroimaging in various types of multisystem atrophy, progressive supranuclear palsy, and dementia with Lewy bodies. The article is illustrated with own MRI scans of the brains of patients with PD and other forms of parkinsonism.

Role of Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy in Differentiation Between Benign and Malignant Ovarian Lesions

It is crucial to rule out any cancer in an ovarian mass. Following initial diagnosis, it is the most essential issue and has a significant impact on how the patient will be managed. Therefore, an accurate way to distinguish between a benign and malignant ovarian mass would allow for the best clinical evaluation and could perhaps lessen the number of unneeded laparotomies performed on benign lesions disease.

Role of Magnetic Resonance Imaging in the Diagnosis and Prognosis of Cardiomyopathy

Role of Magnetic Resonance Imaging in the Diagnosis and Prognosis of Cardiomyopathy

The role of magnetic resonance imaging and computed tomography in oral squamous cell carcinoma patients' preoperative staging.

The aim of the study was to evaluate the accuracy of MRI and CT with regard to the detection of lymph node metastases based on the data of specific patients with OSCC who received bilateral neck dissection. In a retrospective analysis from 01/2014 to 12/2020 patients who underwent primary tumor resection and bilateral neck dissection were evaluated. 174 preoperative MRI (78.74%, N=137) and CT (21.26%, N=37) were correlated with the histopathological findings. CT had a sensitivity of 67% and specificity of 68% (p=0.76). MRI showed an overall sensitivity of 66% and a specificity of 68% (p=0.76). In 52.87% of all cases no differences between cN and pN were found. MRI is the method to overestimate lymph node involvement compared to CT (overestimation in 27% vs. 21.62%). The current data indicate that MR and CT show poor efficacy in the detection of cervical metastases. Accordingly, attention must be paid to alternatives to correct local staging modalities. The application of structured bilateral neck dissection needs to be questioned.

Role of magnetic resonance imaging for preoperative prediction of early biochemical failure in localized prostate cancer.

The purpose of our study was to assess preoperative clinical biological and Magnetic Resonance Imaging (MRI) predictive factors of early biochemical failure (BF), defined as persistence of significant post-operative plasmatic prostate specific antigen (PSA) level after radical prostatectomy (RP) in patients with localized prostate cancer (PCa). In a retrospective cohort study we included 142 patients from our university hospital with newly diagnosed PCa, who underwent 3T multiparametric MRI prior to RP. Only the MRI target lesions [Prostate Imaging Reporting and Data System (PIRADS) ≥3] with histological correspondence were considered significant. Clinical, biological, MRI and pathological preoperative data were studied. We performed univariate and multivariate logistic regression analysis to identify significant parameters associated with early BF. Early BF occurred in 14% of patients (20/142). Patients with BF had higher PSA level at diagnosis, Gleason score, number of positive biopsies, size of the largest positive biopsy and higher National Comprehensive Cancer Network (NCCN) risk score (P<0.001 for all). According to MRI, they also had higher T stage and a higher size of capsular contact (P<0.001 for all). In contrast, there was no difference concerning neither ADC value, perfusion profile and zonal location of the index lesion. In multivariate analysis, the best combination of predictive factors of early BF was the association of preoperative Gleason score ≥4+3 [odds ratio (OR) =6.8 (1.4-32.5); P=0.002] and T stage ≥3 on preoperative MRI [OR =17.4 (3.2-94.9); P<0.001] with an area under the curve (AUC) of 0.89 [99% confidence interval (CI): 0.77-1], a negative predictive value of 94% and a positive predictive value of 75%. Combination of simple preoperative biomarkers as Gleason score and T stage according to MRI accurately stratify the risk of early BF following RP. These results emphasize the pivotal role of preoperative MRI for the management of localized PCa.

A STUDY ON ROLE OF MRI IN EVALUATING PAINFUL HIP JOINT AT A TERITIARY CARE HOSPITAL

Objectives: Hip pain can be diagnostic challenge for the clinician. Our study aimed to access the Role of Magnetic Resonance Imaging (MRI) in diagnosing hip pathologies. This study was retrospective study done on 55 patients refe Methods and materials: rred to Department of Radiodiagnosis, PESIMSR, Kuppam, Andhra Pradesh, India. All 55 patients were subjected to MRI hip study using T1, T2, STIR and PD FS sequences. Data collected was tabulated and statistical analysis was done. Out of 55 patients, 47 patients showed abnormality and 8 Results: patients had no abnormality detected. MRI is the modality of choice for the dia Conclusion: gnosis of hip joint pain as it is safe, non-invasive and depicts accurate anatomical details. MRI is an excellent modality for the diagnosis of many hip conditions which shows non remarkable subtle ndings in radiographs and CT.

Role of Magnetic Resonance Imaging in Morphometric Alterations of Corpus Callosum in Stroke Patients.

Corpus callosum plays a role in interhemispheric integration, language, intelligence, and creativity of individuals, hence variations in corpus callosum size are seen in various neurological diseases such as Alzheimer's and bipolar affective disorder. While the dimensions differ based on gender, age, and ethnicity, pathological variations are seen with some diseases such as vascular dementia, leukoaraiosis, stroke, and carotid artery stenosis. This study was conducted to compare the morphometric alterations of the corpus callosum between normal subjects and stroke patients using magnetic resonance imaging (MRI). This was a case-control study conducted on 84 subjects divided into cases and control groups. The widths of the genu, body & splenium, and anterior-posterior (AP) diameter of the corpus callosum were measured and the values were compared among the two groups. Student's t-test and regression analysis were utilized for the analysis of data and p<0.05 was considered statistically significant. Sixteen patients (19.04%) belonged to the age range of 18-40 years, 32 (38.09%) belonged to the age range of 41-60 years and 36 (42.8%) belonged to the age group of >60 years. There was no discrepancy between cases and controls or between the age groups. The mean width of genu, body & splenium, and AP diameter was compared between normal individuals and stroke patients. It was noted to be significantly lesser in cases than in controls. The morphometric indicesi.e., width of genu, body & splenium, and AP diameter of the corpus callosum in cases versus controls were noted to be 9.8 ± 1.2 vs. 10.27 ± 0.3 mm, p=0.12; 5.1±0.9 vs. 5.3±0.24 mm, p=0.25; 12.11 ± 9.65 vs. 12.52 ± 13.9 mm, p=0.04 (significant) and 71.22±3.1 vs. 72.32±1.2, p=0.23, respectively. This study showed that patients with stroke have a significant reduction in morphometric indicesi.e., widthof genu, body & splenium, and the APdiameter of the corpus callosum when compared to normal individuals.

The Role of Magnetic Resonance Imaging (MRI) in the Diagnosis of Pancreatic Cystic Lesions (PCLs)

Pancreatic cystic lesions (PCLs) are a common incidental finding on cross-sectional imaging. Given the high signal to noise and contrast resolution, multi-parametric capability and lack of ionizing radiation, magnetic resonance imaging (MRI) has become the non-invasive method of choice to predict cyst type, risk stratify the presence of neoplasia, and monitor changes during surveillance. In many patients with PCLs, the combination of MRI and the patient's history and demographics will suffice to stratify lesions and guide treatment decisions. In other patients, especially those with worrisome or high-risk features, a multimodal diagnostic approach that includes endoscopic ultrasound (EUS) with fluid analysis, digital pathomics, and/or molecular analysis is often necessary to decide on management options. The application of radiomics and artificial intelligence in MRI may improve the ability to non-invasively stratify PCLs and better guide treatment decisions. This review will summarize the evidence on the evolution of MRI for PCLs, the prevalence of PCLs using MRI, and the MRI features to diagnose specific PCL types and early malignancy. We will also describe topics such as the utility of gadolinium and secretin in MRIs of PCLs, the limitations of MRI for PCLs, and future directions.

The usefulness of magnetic resonance imaging for the prognostic evaluation of patients with heart failure [Version 1; Peer Review - In process

Introduction: the role of magnetic resonance imaging (MRI) in heart failure (HF) is much discussed, both in the etiological and prognostic evaluation of this disease. Therefore, a description of the usefulness of MRI would show us its role in the evaluation of prognosis in patients with HF of various etiologies. Aim: to describe the usefulness of MRI for the evaluation of prognosis in patients with HF of various etiologies. Methodology: a narrative literature review was carried out by means of a search in databases such as PubMed, Scopus, Elsevier and Springer (BMC). Results: cardiac magnetic resonance (CMR) is superior to echocardiography in assessing left ventricular volumes and function with better reproducibility, also when analyzing systolic abnormalities and characterizing viable myocardial tissue, as well as that with the presence of myocardial fibrosis. Precisely, the detection of myocardial fibrosis has a predictive value for adverse events in patients with HF. Conclusion: CMR is useful to identify previously undetected pathology and pathologies that are difficult to diagnose. Thus, its use is associated with better diagnostic performance and, therefore, a better predictor of adverse events in patients with HF

The role of magnetic resonance imaging (IMR) in the diagnosis of tumor and somatic pathologies. Introduction.

Magnetic resonance imaging (MRI) is a non-invasive investigation, which allows the anatomical investigation, but also the physiological processes of the human body, for the diagnosis of tumors, somatic diseases, etc. MRI can be diversified into neuroimaging, cardiovascular, musculoskeletal, functional, angiography, and other special-izations and techniques.The purpose of the work. Analysis of the possibilities and effectiveness of the application of MRI in the diagnosis of tumors and somatic pathologies in one year of activity (2021-2022) at an Ingenia Ambition-1.5T installation and the annual functional possibilities. Materials and methods. MRI investigations were performed at the Ingenia Ambition-1.5T Philips Magnetic Resonance Facility on 8,789 patients aged between 1 month and 84 years, with tumors and somatic diseases, applying the techniques and protocols corresponding to the investigative level. The protocols were applied in different planes (axial, coronary, sagittal, oblique), and techniques such as T2w, T1w, PD, FLAIR, SWI, DWI, DWI_ZOOM, DTY, DWI_BS, STIR, SPIR, T1_mDICSON, T2_mDIXON, 3D-DIR, T1w+Cdyn, T2*perfusion, ASL perfusion, 3D pCASL perfusion, Spectro, BTFE, dual FFT, MRSP, mDIXON_quantification.

Unilateral developmental absence of internal carotid artery with contralateral middle cerebral artery occlusion.

Developmental absence of the internal carotid artery (ICA) is a rare congenital anomaly that results from an insult to the third aortic arch or dorsal aorta during early embryogenesis. Patients are often asymptomatic and are diagnosed incidentally during imaging to investigate neurological complaints. We report a rare finding of an absent ICA during a workup of stroke in a middle-aged patient. CT brain perfusion (CTP) and CT angiography (CTA) revealed the right middle cerebral artery (MCA) thrombotic stroke with the demonstration of contralateral left ICA absence. The patient showed spontaneous recovery, and no thrombolysis or neurointervention was considered. This article highlights the importance of screening the head CT on bone window settings in case of the non-visualization of ICA to differentiate congenital absence from a steno-occlusive disease. It also illustrates the role of Magnetic resonance imaging (MRI) and MR Angiography (MRA) in demonstrating further possible vascular anomalies, structural brain malformations, and collateral circulation.

The role of magnetic resonance imaging in the early diagnosis of chronic lymphocytic inflammation (CLIPPERS syndrome)

Background: Chronic lymphocytic inflammation with perivascular contrast enhancement in the pons responsive to steroids (CLIPPERS) is a rare and relatively new pathology and magnetic resonance imaging (MRI) is highly important in its diagnosis.&#x0D; Clinical case description: The analysis of the MRI results revealed typical changes characteristic of CLIPPERS, such as contrast-positive small-point and curvilinear lesions of the pons, medulla oblongata and midbrain, as well as of the cerebral peduncles and cerebellum. In addition to the changes we described, according to the literature, lesions of the white matter of the large hemispheres and thalami may also be observed in the syndrome of chronic lymphocytic inflammation.&#x0D; Conclusion: MRI not only enables one to achieve high-quality neuroimaging of CLIPPERS, but also allows avoiding invasive, traumatic diagnostic methods.

Synthesis, characterization, and electrocatalytic behaviour of hydrothermally grown nanostructured La2 O3 and La2 O3 /K-complex.

Rare earth metals play a conspicuous role in magnetic resonance imaging (MRI) for detecting cancerous cells. The alkali metal potassium is a neurotransmitter in the sodium-potassium pump in biomedical sciences. This unique property of rare earth metals and potassium drew our attention to carry forward this study. Therefore, in this work, previously synthesized potassium (K) complexes formed by the reflux of 4-N,N-dimethylaminobenzoic acid (DBA) and potassium hydroxide in methanol, and named [(μ2-4-N,N-dimethylaminobenzoate-κO)(μ2-4-N,N-dimethylaminobenzoic acid-κO)(4-N,N-dimethylaminobenzoic acid-κO) potassium(I) coordination polymer)] were treated hydrothermally with La2 O3 nanomaterials to obtain a nanohybrid La2 O3 /K-complex. After that, the K-complex was analyzed using single-crystal X-ray diffraction and 1 H and 13 C NMR spectroscopy. In addition, the structural and morphological properties of the as-prepared nanostructured La2 O3 /K-complex were also characterized, which involved an investigation using X-ray diffraction (XRD)spectroscopy, Fourier transform infrared (FTIR) spectroscopy, atomic force spectroscopy (AFM), transmission electron microscopy (TEM), and energy dispersive X-ray (EDX) analysis. After this, the electrochemical redox behaviour of the synthesized nanohybrid material was studied using cyclic voltammetry (CV) and differential pulse voltammetry (DPV). Therefore, the results from these studies revealed that the as-prepared material was a La2 O3 /K-complex that has a promising future role in sensing various analytes, as it showed effective electrocatalytic behaviour.

Large-scale cross-sectional online survey on patient-neurologist communication, burden of disease assessment and disease monitoring in people with multiple sclerosis.

Management of multiple sclerosis (MS) requires a high level of communication between health care professionals (HCPs) and people with MS (pwMS) including profound investigation and discussion of symptoms to identify therapeutic needs. For treatment decisions, monitoring of disease activity is important, in this respect self-monitoring devices and apps, as well as magnetic resonance imaging are important tools. MS Perspectives is a cross-sectional online survey conducted in Germany which was designed to collect data, among others, on the communication between pwMS and HCPs regarding treatment goals, symptom assessment, usage of devices and apps to self-monitor health functions, as well as to identify patients' attitude toward the role of magnetic resonance imaging (MRI). Between December 2021 and February 2022, 4,555 pwMS completed the survey. In total, 63.7% of participants reported that treatment goals have been discussed with their HCPs. Symptoms worsening in the past 12 months independent of relapses was more often reported by pwMS than inquired by HCPs, according to patients' report. Devices or apps for health monitoring were used by less than half of participants. Frequency of MRI controls was much lower in participants with longer compared to shorter disease duration (47.5 vs. 86.3%). The proportion of patients with annual or semiannual scans was highest among pwMS receiving infusion therapy (93.5%), followed by oral medication (82.5%) and injectables (73.4%), and lowest for pwMS without immunotherapy (58.2%). MS Perspectives identified a rather low patient involvement regarding treatment goals and symptom assessment in clinical practice. Regarding this and our findings for health self-monitoring and MRI usage, strategies for improving patient-HCP communication and disease monitoring may be considered.

Association between Migraine Patterns and White Matter Hyperintensities in MRI Brain: A Cross-sectional Analytical Study

Introduction: Migraine is a neurological condition characterised by recurrent episodes of headaches. The role of Magnetic Resonance Imaging (MRI) as a diagnostic tool in evaluating migraines is yet to be fully understood. Changes that occur in the blood vessels during a migraine attack lead to hypoperfusion in the brain, causing neurovascular dysfunction and cortical spreading depression. These events are manifested as White Matter Hyperintensities (WMHs) in brain MRI. Aim: To determine the association between migraine patterns and WMHs in the MRI brain scans. Materials and Methods: A cross-sectional analytical study was conducted at Department of Neurology, Mar Baselios Medical Mission Hospital, a tertiary care centre for Neurology and Movement disorders in South India, from June 2021 to June 2022. The study included 100 patients aged between 18 and 50 years who had been diagnosed with migraine. A questionnaire was prepared, which included various parameters such as the presence or absence of aura, duration, frequency, tolerability, disability, intensity of pain, nausea, and resistance to treatment. The severity of migraine in the patients was evaluated using the Migraine Intensity and Severity Evaluation (MIGSEV) scale, which considers parameters such as pain intensity, attack duration, nausea, disability, tolerability, treatment resistance, and attack frequency. Based on this assessment, patients were classified into Grade I, II, or III. After obtaining informed consent, MRI brain scans were performed on all patients. Patients exhibiting WMHs underwent Gadolinium IV contrast, and those with contrast-enhancing lesions underwent whole spine screening and CSF analysis testing. Statistical Package for the Social Sciences (SPSS) version 20.0 was used for data analysis. The statistical tests employed included the MannWhitney test, Kruskal-Wallis test and Spearman coefficient. Results: The mean age of the participants was 28.60±7.0 years. WMHs were present in 47 out of 100 patients (47%). A significant association was observed between WMHs and aura (U=487.50) (p-value&lt;0.001). Multivariate analysis revealed that migraine severity grade, pain intensity during the attack, nausea, disability, tolerability, migraine duration, and resistance to treatment were statistically significant with a p-value of &lt;0.001. Conclusion: WMHs in MRI were more significant in patients with Grade III MIGSEV scores. There was a statistically significant association between the number of WMHs, high intensity of pain, vomiting, severe disability, and tolerability during a migraine attack. Therefore, these parameters can be considered as risk factors for developing WMHs in the brain MRI of migraine patients.

Role of magnetic resonance imaging in detection and characterization of perianal fistula

Background: Perianal fistula is a common but fairly complicated condition, which needs in-depth evaluation of the fistula track for proper treatment and complete cure. Clinical examination does play its significant role; however, the ramifications of track, blind ending tracks, and secondary collections are some blind points for the clinicians which are very well-demonstrated by magnetic resonance imaging (MRI). Surgical planning for complete cure of perianal fistula is highly dependent on the grade and associated complications of fistula. Aims and Objectives: The objective of our study is to – (i) evaluate the role of MRI in detection as well as characterization of perianal fistula; (ii) classify and grade the perianal fistula according to the “St. James University Hospital grading scheme” and the “Park’s classification;” and (iii) evaluable the perianal fistula as per the following: Internal opening of the track; high versus low lying perianal fistulae; transsphincteric/extra sphincteric/supralevator extension of the fistula; secondary tracts/ramifications/impending fistulae; and ischioanal abscess/ischiorectal abscesses/horseshoe collection. Materials and Methods: An observational type of study was conducted over a duration of 24 months. Patients with suspected perianal fistulae with one or many external openings were prospectively selected for MRI evaluation of their fistula tracks. MRI findings were then evaluated according to “St. James’s University Hospital MR Imaging Classification of Perianal Fistulae.” Results: Out of 30 clinically diagnosed patients, all patients demonstrated presence of perianal fistula. Out of total 30 patients, majority had external opening at 7 O’clock position (33.3%) followed by 5 O’clock position (26.6%). Out of total 30 patients, majority had internal opening at 6 O’clock position (43.3%) followed by 3 O’clock position (13.3%). Conclusion: MRI imaging of perianal fistula is a simple and non-invasive method and is extremely useful for the surgical planning. It has a definite place in imaging of complex perianal disease as it provides high resolution images of perianal region anatomy, allowing characterization, classification, and grading of the fistula. This thus guides in the surgical decision making and helps in successful treatment of disease.

Diagnostic and Interventional Role of Magnetic Resonance Imaging and Ultrasound in Painful Wrist Conditions

Diagnostic and Interventional Role of Magnetic Resonance Imaging and Ultrasound in Painful Wrist Conditions

Role of magnetic resonance imaging in urinary bladder carcinoma: A tertiary care experience

Background: Bladder cancer is the most common malignancy of the urinary tract. Pre-operative tumour staging and grading play a significant role in treatment planning and prognosis estimation for bladder cancer. Aims and Objectives: This study aims to evaluate the utility of multiparametric-magnetic resonance imaging (mp-MRI) in detecting and staging bladder cancers and hence its role in final management. Materials and Methods: A total of 40 patients with documented urinary bladder mass undergoing mp-MRI before transurethral resection of bladder tumours for primary bladder cancer were identified and compared with post-operative histopathological reports. The data were collected and analysed using SPSS software. Results: The mean age in the study population was 53.68 ± 13.2 years, including 7 (17.5%) females and 33 (82.5%) males. Twenty-three (57.5%) of our patients had muscle invasion on the MRI pelvis. In muscle-invasive urothelial carcinoma, there were significantly more patients with Vesical Imaging-Reporting and Data System (VIRADS) 3, VIRADS 4 and VIRADS 5 than in non-muscle invasive urothelial carcinoma. The proportion of patients with VIRADS 1 and VIRADS 2 on MRI pelvis was significantly lower in muscle-invasive urothelial carcinoma than in non-muscle-invasive urothelial carcinoma (P = 0.0001). Histopathology and muscle invasion on the MRI pelvis agree well in the current study (κ = 0.742; P = 0.0001). There was an overall concordance rate of 87.5% and an overall discordance rate of 12.5% between histopathology and muscle invasion on the MRI pelvis. The sensitivity, specificity, area under the curve, positive predictive value, negative predictive value and diagnostic accuracy of the mp-MRI scan were 87.5%, 87.5%, 0.88, 91.3%, 82.35% and 87.50%, respectively. Conclusion: The mp-MRI and VIRADS scoring is an effective comprehensive tool with satisfactory sensitivity, specificity and diagnostic value for detecting muscle invasiveness of primary bladder cancer. We recommend VIRADS scoring for all bladder cancer patients for better pre-operative staging and overall management.