{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:04:27Z","timestamp":1790183067922,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While the current Vesical Imaging Reporting and Data System (VI\u2010RADS) provides a valuable tool for evaluating bladder cancer, it is not tailored to the ureteral orifices and primarily relies on subjective evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To identify significant parameters from MRI for diagnosing muscle\u2010invasive bladder cancer (MIBC) at the ureteral orifice, and to evaluate their incremental value to VI\u2010RADS for readers of varying experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Type<\/jats:title>\n                    <jats:p>Retrospective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Development cohort: 81 patients with ureteral orifice bladder tumors (mean age, 68\u2009\u00b1\u20099; 60 men). External validation cohort: 34 patients (mean age, 63\u2009\u00b1\u20095; 22 men).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Field Strength\/Sequence<\/jats:title>\n                    <jats:p>3.0\u2009T; fast spin\u2010echo T2\u2010weighted imaging, single\u2010shot echo planar diffusion\u2010weighted imaging, 3D spoiled gradient echo T1\u2010weighted dynamic contrast\u2010enhanced imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Assessment<\/jats:title>\n                    <jats:p>\n                      Four radiologists of varying experience independently assigned VI\u2010RADS scores. Quantitative parameters (tumor length, tumor contact length [TCL], stalk width [SW], and K\n                      <jats:sup>trans<\/jats:sup>\n                      ) and qualitative parameters were assessed. Pathology was the reference standard.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Tests<\/jats:title>\n                    <jats:p>\n                      Intraclass correlation coefficient, weighted\n                      <jats:italic>\u03ba<\/jats:italic>\n                      analysis, independent samples\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test, Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test, chi\u2010square test, receiver operating characteristic curve analysis, univariate and multivariate logistic regression, 1000 bootstrap resamples, DeLong's test, and McNemar's test with Bonferroni correction. Significance was defined as\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05, with\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.008 for multiple comparisons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Multivariate analysis identified TCL (odds ratio [OR]\u2009=\u20091.12) and stalk width (OR\u2009=\u20091.74) as independent predictors. In both cohorts, the TCL\u2009+\u2009SW\u2010modified VI\u2010RADS significantly improved sensitivity over the original VI\u2010RADS for diagnosing MIBC at the ureteral orifice in two junior radiologists. The TCL\u2009+\u2009SW\u2010modified VI\u2010RADS did not significantly improve sensitivity compared with the TCL\u2010modified VI\u2010RADS in either cohort (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.25\u20130.50).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Conclusion<\/jats:title>\n                    <jats:p>The integration of TCL and stalk width into the VI\u2010RADS improves diagnostic performance for MIBC at the ureteral orifice, particularly for less\u2010experienced radiologists. Nevertheless, external validation in larger, multicenter cohorts is required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence Level<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Technical Efficacy<\/jats:title>\n                    <jats:p>Stage 2.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jmri.70401","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:23:58Z","timestamp":1782977038000},"page":"957-969","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Quantitative Modification of\n                    <scp>VI<\/scp>\n                    \u2010\n                    <scp>RADS<\/scp>\n                    for Bladder Cancer at the Ureteral Orifice: A Reader Study on\n                    <scp>MRI<\/scp>\n                    With Varying Experience Levels"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6051-5212","authenticated-orcid":false,"given":"Erjia","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Radiology, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3988-5865","authenticated-orcid":false,"given":"Li","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing 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