SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
This article is part of the Research TopicAdvances in Oncological Imaging TechniquesView all 20 articles
The role of MRI in detection and staging of upper urinary tract cancer: a systematic review of the literature
Provisionally accepted
Cecile Manceau1*
Lucas Bento2
Serge Brunelle3
Thomas Prudhomme2Bajeot Anne Sophie2Xavier Game2Michel Soulie2Delchier Marie Charlotte2
Fatima-Zohra Mokrane2Mathieu Roumiguie2- 1Centre Hospitalier Universitaire de Montpellier, Montpellier, France
- 2Centre Hospitalier Universitaire de Toulouse, Toulouse, Occitanie, France
- 3Institut Paoli-Calmettes (IPC), Marseille, Provence-Alpes-Côte d'Azur, France
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IntroductionUpper urinary tract tumors (UUTT) are imprecisely diagnosed. Recent data have shown a benefit to adding systemic treatments to advanced local stage tumor (≥T2). MRI has provided useful information to evaluate the local Tstage of urinary bladder tumors, which may be used for the UUTT.Objective was to review the literature on the diagnostic and staging capability of MRI for UUTT. Additionally, the methods of performing MRI on the UUT were evaluated.Methods: This review was conducted according to the PRISMA using MEDLINE and EMBASE. All original articles published between January 2000 and February 2024 investigating MRI diagnosis and staging performances of MRI for patients with suspected UUTT were included in this research.Results15 studies were included consisting of 999 patients and 593 with UUTT. A wide heterogeneity of sequences was observed. While standard acquisition (T1 weighted + T2 weighted) showed insufficient diagnosis performances, dynamic contrast imaging (DCE) and diffusion weighted imaging (DWI) presented strong diagnostic scores for pooled sensitivity (92.5% and 93.2%), specificity (76.7% and 84.2%) and accuracy of diagnosis (91.1% and 90.1%) respectively. DWI and apparent diffusion coefficient (ADC) seemed to be informative for staging and prognostic evaluation.Discussion and ConclusionMRI shows strong potential to positively enhance UUTT diagnosis and staging. Despite heterogeneous data and limited evidence, findings of this study suggest that further large multicentric studies should be conducted in order to better evaluate MRI diagnostic performances of UUT, with a predefined standard acquisition compared to the pathology report of radical nephroureterectomy or long-term follow-up by medical imaging. We hope to establish a MRI UUTI-RADS (Upper Urinary Tract Imaging-Reporting and Data System) score for predicting muscle invasion and tumor stage.
Keywords: MRI, DWI, ADC, Upper urinary tract tumour, upper urinary tract diagnosis, upper urinary tract staging, upper urinary tract prognosis
Received: 19 Jan 2025; Accepted: 20 Jan 2026.
Copyright: © 2026 Manceau, Bento, Brunelle, Prudhomme, Anne Sophie, Game, Soulie, Marie Charlotte, Mokrane and Roumiguie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Cecile Manceau
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