Ricerc@Sapienza

The research activities in the field of integrated diagnostics for bladder cancer focus on advancing multiparametric MRI (mpMRI) as a quantitative and standardized tool for precision oncology. Core developments include the optimization of loco-regional staging and the creation and validation of the VI-RADS score, designed to differentiate muscle-invasive (MIBC) from non–muscle-invasive bladder cancer (NMIBC). This framework, is done under the umbrella of the American College of Radiology VI-RADS committee, of which Prof. Panebianco is Chair. This has led to the delineation of a “hematuria MRI pathway,” has been incorporated into the European Association of Urology (EAU) Guidelines as the reference imaging approach for T1–T2 differentiation.

Building upon these foundations, ongoing studies focus on assessing treatment response to neoadjuvant chemotherapy and immunotherapy through the development of the NAC–VI-RADS scoring system, an adaptation of the original score that captures morpho-functional changes following systemic treatment. Parallel research extends mpMRI to Upper Tract Urothelial Carcinoma (UTUC) involving the ureters and renal pelvis, aiming to standardize loco-regional staging and to establish a dedicated MRI-based score and structured report for differentiating invasive from non-invasive disease, supporting more personalized therapeutic decisions.

The imaging program is expanding toward a multi-omic integration, combining radiomics, genomics, transcriptomics, and liquid biopsy data to identify predictive biomarkers and refine patient stratification. These efforts form the foundation for developing predictive, patient-specific models.

In this context, two major prospective studies are being launched: the CutLess Trial, focused on imaging-guided and organ-sparing management of non-muscle invasive bladder cancer, and the EORTC StarBurst Trial, aimed at evaluating MRI and biomarker integration for response assessment and longitudinal follow-up. Together, these initiatives position the integrated diagnostic program as a driver of innovation toward personalized, minimally invasive, and data-informed care for patients with urothelial carcinoma.