Akintelure Daniel, Akintelure Simon, Al-Ibraheem Hasan A
Urology, Royal Gwent Hospital, Newport, GBR.
College of Medicine, All Saints University School of Medicine, Roseau, DMA.
Cureus. 2025 Jul 23;17(7):e88623. doi: 10.7759/cureus.88623. eCollection 2025 Jul.
This narrative review synthesizes the current evidence on multiparametric magnetic resonance imaging (mpMRI) in bladder cancer staging, emphasizing the clinical significance of the BladderPath trial, a prospective randomized comparison of mpMRI versus conventional transurethral resection of bladder tumors (TURBT). While TURBT remains the standard diagnostic approach, emerging evidence suggests that mpMRI-based pathways may offer advantages in terms of diagnostic speed and staging accuracy. The BladderPath trial reported a median 45-day reduction in the time to definitive treatment with an imaging-first approach without compromising early oncological outcomes. However, these findings must be interpreted with caution because of the trial's limitations, including its restrictive inclusion of patients with suspected muscle-invasive disease. This review contextualizes mpMRI within the broader diagnostic landscape, evaluates its readiness for wider clinical adoption, and outlines key challenges, such as implementation variability, access disparities, and the need for long-term data for informed evidence-based practices.
本叙述性综述综合了目前关于多参数磁共振成像（mpMRI）在膀胱癌分期中的证据，强调了BladderPath试验的临床意义，该试验是mpMRI与传统经尿道膀胱肿瘤切除术（TURBT）的前瞻性随机对照研究。虽然TURBT仍然是标准的诊断方法，但新出现的证据表明，基于mpMRI的诊断途径在诊断速度和分期准确性方面可能具有优势。BladderPath试验报告称，采用以影像检查为先的方法确定最终治疗时间的中位数减少了45天，且不影响早期肿瘤学结局。然而，由于该试验存在局限性，包括对疑似肌肉浸润性疾病患者的纳入标准较为严格，这些研究结果必须谨慎解读。本综述将mpMRI置于更广泛的诊断背景中，评估其在临床上更广泛应用的准备情况，并概述了关键挑战，如实施的变异性、获取的差异以及为基于证据的明智实践提供长期数据的必要性。
