Bladder cancer (BCa) is the seventh most common cancer affecting the male population, and 10th most common cancer globally.1 Urothelial carcinomas make up more than 90% of all cases, with the remaining 10% comprising less common histologies, such as squamous cell carcinoma, adenocarcinomas, and lymphomas.2 BCa morphology is very variable, changing with tumor growth and progression. Carcinoma-in-situ (CIS) grows horizontally, whereas invasive BCa usually presents with exophytic polypoid masses or sessile infiltrative lesions. The invasion of the muscularis propria is critical, affecting management and prognosis, which is significantly worse in muscle-invasive BCa (MIBC) in comparison to non-muscle-invasive BCa (NMIBC).3 This pivotal aspect can be determined by pathological and radiological evaluations, placing them in the center of diagnostic workup strategies for subsequent decisions regarding treatment strategies.2

The most frequently presenting symptom of BCa is hematuria and international guidelines endorse physical examination and ultrasound (US) study as the first step in diagnostic workup of hematuria. Imaging modalities are critical for detection and description of bladder irregularities; however cystoscopic evaluation and subsequent biopsy of the detected abnormalities are required for final diagnosis.

Whereas not helpful in diagnosis and management of CIS,1 the imaging modalities, including Computed Tomography (CT)-Urography, US, and Magnetic Resonance Imaging (MRI) are essential in workup and staging of MIBC and metastatic BCa. The assessment of spread of disease by lymph nodes and/or other organs requires CT and MRI application. Recently the Node-RADS (Node Reporting and Data System) score system was developed to standardize the assessment of lymph node involvement by CT and MRI, assisting tumor staging.4