VI-RADS quality score aids muscle invasion detection in small bladder tumors, especially for less experienced readers

In small bladder tumors (<3 cm), higher Vesical Imaging Reporting and Data System (VI-RADS) quality scores improved positive predictive value for muscle invasion from 22.7% to 51.0% (p=0.004) and accuracy from 71.7% to 81.6% (p=0.023), especially for a less experienced reader.

• VI-RADS quality score inter-reader agreement was substantial (k = 0.628–0.702) among three readers.
• Higher quality scores were associated with increased T2-weighted VI-RADS scores (OR 2.95, 95% CI 1.17–7.43, p=0.021); no significant performance difference in tumors ≥3 cm.
• Only one less experienced reader was included, so the improved accuracy for small tumors in that group requires external validation.

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