Introduction: To evaluate the performance of the Vesical Imaging-Reporting and Data System (VIRADS) in differentiating muscle-invasive and nonmuscle-invasive bladder cancer and whether this reporting system improves inter-reader agreement. Methods: Sixty-four cases of multiparametric 3 tesla bladder MRI from January 2014 to May 2020 were reviewed retrospectively. T2-weighted, diffusion and post-contrast images were reviewed. All magnetic resonance images were reported by a radiologist with 15 years' experience (Reader 1) and a final year radiology trainee with a special interest in urogenital imaging with 3 years of experience (Reader 2). Both readers were blinded to clinical history and histopathology results when scoring each lesion. Results: The sensitivity and specificity for differentiating MIBC and NMIBC were 91% and 68%, respectively, for Reader 1 and 91% and 63%, respectively, for Reader 2. The inter-reader agreement for assigning VIRADS scores was 0.79. The area under the receiver operator curve for Reader 1 and 2 were not significantly different (Reader 1 = 0.79, Reader 2 = 0.77, P = 0.83). Conclusions: Staging of bladder cancer prior to treatment can be accurately and reliably diagnosed using VIRADS, a novel, standardised reporting system for bladder MRI.

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Introduction: Gallbladder cancer (GBC) is a rare malignancy in Australia with an incidence of less than 6 per 100000 population. There is marked geographic variation in incidence with the majority of the literature from these endemic regions. The aim of the paper is to assess the incidence, characteristics and outcomes of GBC in a nonendemic region. Methods: A retrospective review of all patients diagnosed with GBC in the Australian Capital territory over a 10-year period was undertaken. This included hospital medical records and a prospectively collected cancer database. Cases were also identified from ACT-wide pathology laboratories where specimens were sent for histological analysis. Adults with GBCs regardless of metastatic state were included. Patient characteristics including presenting features, histology, treatment received and survival were assessed. Results: 58 GBCs (Primary=74.1%) were identified. The incidence of primary GBC was 2.7/100,000 person-years with a mean age of onset at 68.5 years with a female preponderance (w72.5%). The mean survival was 2.3 years with an overall five-year survival of 51%. 88.4% of patients were symptomatic with right upper quadrant pain and/or a mass, jaundice or weight loss. Incidental GBC was found in 11.6% of the patients. Adenocarcinoma was noted in 93% of primary cases with most being at Stage 3A on diagnosis. 60.5% underwent surgery. Conclusion: GBC is rare cancer in the Australian population with majority of the symptomatic patients being diagnosed at a late stage. Incidental cancers are a significant proportion of patients. The overall outcome of this cancer is poor.

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