Objective To explore the diagnostic accuracy and correlation of Vesical Imaging-Reporting and Data System (VI-RADS) and apparent diffusion coefficient (ADC) value histogram in muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC). Methods Multiparametric MRI of 81 patients with pathologically confirmed bladder cancer after transurethral resection of bladder tumors or radical cystectomy was retrospectively analyzed. Two radiologists scored all MRI examinations according to the VI-RADS criteria and ADC histogram parameters were obtained. Differences of VI-RADS and quantitative parameters between MIBC and NMIBC were evaluated. The diagnostic performance of the VI-RADS, ADC histogram parameter with statistically significant difference and combined diagnosis were evaluated for predictive ability of each model using the receiver operating characteristic (ROC) curves. Results of 81 patients including 40 (49.4%) MIBC and 41 (50.6%) NMIBC, 53 (65.4%) lesions with VI-RADS≥3 points, and 28 (34.6%) lesions with VI-RADS<3 points were analyzed. VI-RADS had the highest area under the ROC curve (AUC) of 0.903 among all parameters. The ADCmin, ADCmedian, ADCmean, 10% ADC (10th percentile ADC value), 25% ADC (25th percentile ADC value), 75% ADC (75th percentile ADC value), 90% ADC (90th percentile ADC value) of MIBC were significantly lower than those of NMIBC and were negatively correlated with the VI-RADS score (r=-0.439, -0.526, -0.305, -0.368, -0.547, -0.527, -0.396, all P<0.05) whereas kurtosis and entropy of MIBC were significantly higher than that of NMIBC and had positive correlation with the VI-RADS score (r=0.593, 0.296; P<0.05). VI-RADS+75% ADC (P=0.038), VI-RADS+ADCmedian (P=0.018), and VI-RADS+ADCmean (P=0.029) showed statistical differences compared to VI-RADS alone with the highest AUC value obtained by combining ADCmedian with VI-RADS (AUC=0.950). Conclusion VI-RADS and ADC histogram analysis can effectively. discriminate between MIBC and NMIBC. ADC histogram can supplement VI-RADS. [ABSTRACT FROM AUTHOR]