VI-RADS scoring criteria for alternative risk-adapted strategies in the management of bladder cancer during the COVID-19 pandemic

This ability to differentiate non–muscle-invasive from muscle invasive BCa was used to predict BCa upstaging at repeat TURBT in a recent prospective series (area under the receiver operating characteristic curve 0.93, 95% CI 0.87– 0.97) and therefore VI-RADS has been proposed for avoiding repeat TURBT according to the European Association of Urology guidelines. This may be particularly useful in cases lacking muscularis propria in the specimen or in the setting of a unifocal, small, high-grade Ta/T1 tumor, for which a preoperative VI-RADS score of 1–2 may indicate a low likelihood of tumor understaging and therefore patients may be quickly directed to appropriate adjuvant intravesical therapy for follow-up. This relatively safe approach might minimize potential exposure to COVID19 infection by avoiding a second hospital admission for a surgical procedure that is not devoid of possible complications