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Volume 26
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10.3390/ijms26199570
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Comparative Analysis of CT and MRI Combined with RNA Sequencing for Radiogenomic Staging of Bladder Cancer

by
Joshua Levy
1,2,3,
Toru Sakatani
4,
Kaoru Murakami
4,
Yuki Kita
4,
Takashi Kobayashi
4,
Susan Win
5,†,
Saro Manoukian
5,
Charles J. Rosser
1,6 and
Hideki Furuya
1,7,*
1
Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
2
Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
3
Department of Computational Biomedicine, Cedars-Sinai Medical Center, Los Angeles, CA 90069, USA
4
Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
5
Department of Radiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
6
Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
7
Department of Biomedical Science, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
*
Author to whom correspondence should be addressed.
†
Current address: Diagnostic Radiology, University of California at Los Angeles, Los Angeles, CA 90095, USA.
Int. J. Mol. Sci. 2025, 26(19), 9570; https://doi.org/10.3390/ijms26199570
Submission received: 6 August 2025 / Revised: 26 September 2025 / Accepted: 28 September 2025 / Published: 30 September 2025
(This article belongs to the Special Issue Molecular Diagnostics and Therapeutic Targets in Bladder Cancer (Second Edition))
Review Reports Versions Notes

Abstract

Accurate staging of bladder cancer (BCa) is important for identifying optimal treatment. Currently, clinical tumor staging for BCa relies on computed tomography (CT) scans, but these can lead to under- or overstaging of patients. Recent research suggests that using magnetic resonance imaging (MRI) along with RNA sequencing (RNASeq) gene expression analysis can provide more precise staging. In this study, 31 matched CT scans, MRI images, and formalin-fixed, paraffin-embedded (FFPE) tissues were collected. First, two radiologists reviewed the images for staging BCa. Next, radiomics features were extracted from both CT and MR images, and computational radiogenomics analyses were performed. Subsequently, RNASeq was performed using FFPE tissues of TURBT prior to cystectomy. A radiogenomic analysis was conducted to identify advanced T-stage signatures. Regarding imaging alone, MRI was found to be more accurate in staging >T2 compared to CT scans. Within a retrospective cohort, MRI radiogenomic signatures were more effective in staging patients than CT, with genomic features playing a significant role. Using canonical correlation analysis, we additionally identified radiomic features underlying genomic signatures of advanced tumor stage. When applying these signatures across a small prospective cohort, MRI radiomic data were able to stratify stage; however, the addition of the same genomic features did not improve the sensitivity and specificity of the model. These preliminary results are promising, but additional research with larger sample sizes is needed to draw definitive conclusions and explore further correlations and statistical interactions between genes and imaging features through machine learning techniques as we move radiogenomics to the clinic.
Keywords: muscle-invasive bladder cancer; radiogenomics; artificial intelligence; CT; MRI; RNASeq muscle-invasive bladder cancer; radiogenomics; artificial intelligence; CT; MRI; RNASeq

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MDPI and ACS Style

Levy, J.; Sakatani, T.; Murakami, K.; Kita, Y.; Kobayashi, T.; Win, S.; Manoukian, S.; Rosser, C.J.; Furuya, H. Comparative Analysis of CT and MRI Combined with RNA Sequencing for Radiogenomic Staging of Bladder Cancer. Int. J. Mol. Sci. 2025, 26, 9570. https://doi.org/10.3390/ijms26199570

AMA Style

Levy J, Sakatani T, Murakami K, Kita Y, Kobayashi T, Win S, Manoukian S, Rosser CJ, Furuya H. Comparative Analysis of CT and MRI Combined with RNA Sequencing for Radiogenomic Staging of Bladder Cancer. International Journal of Molecular Sciences. 2025; 26(19):9570. https://doi.org/10.3390/ijms26199570

Chicago/Turabian Style

Levy, Joshua, Toru Sakatani, Kaoru Murakami, Yuki Kita, Takashi Kobayashi, Susan Win, Saro Manoukian, Charles J. Rosser, and Hideki Furuya. 2025. "Comparative Analysis of CT and MRI Combined with RNA Sequencing for Radiogenomic Staging of Bladder Cancer" International Journal of Molecular Sciences 26, no. 19: 9570. https://doi.org/10.3390/ijms26199570

APA Style

Levy, J., Sakatani, T., Murakami, K., Kita, Y., Kobayashi, T., Win, S., Manoukian, S., Rosser, C. J., & Furuya, H. (2025). Comparative Analysis of CT and MRI Combined with RNA Sequencing for Radiogenomic Staging of Bladder Cancer. International Journal of Molecular Sciences, 26(19), 9570. https://doi.org/10.3390/ijms26199570

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