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Abouelkheir RT, Abdelhamid A, Abou El-Ghar M, El-Diasty T. Imaging of Bladder Cancer: Standard Applications and Future Trends. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57030220. [PMID: 33804350 PMCID: PMC8000909 DOI: 10.3390/medicina57030220] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 12/24/2022]
Abstract
The evolution in imaging has had an increasing role in the diagnosis, staging and follow up of bladder cancer. Conventional cystoscopy is crucial in the diagnosis of bladder cancer. However, a cystoscopic procedure cannot always depict carcinoma in situ (CIS) or differentiate benign from malignant tumors prior to biopsy. This review will discuss the standard application, novel imaging modalities and their additive role in patients with bladder cancer. Staging can be performed with CT, but distinguishing between T1 and T2 BCa (bladder cancer) cannot be assessed. MRI can distinguish muscle-invasive from non-muscle-invasive tumors with accurate local staging. Vesical Imaging-Reporting and Data System (VI-RADS) score is a new diagnostic modality used for the prediction of tumor aggressiveness and therapeutic response. Bone scintigraphy is recommended in patients with muscle-invasive BCa with suspected bony metastases. CT shows low sensitivity for nodal staging; however, PET (Positron Emission Tomography)/CT is superior and highly recommended for restaging and determining therapeutic effect. PET/MRI is a new imaging technique in bladder cancer imaging and its role is promising. Texture analysis has shown significant steps in discriminating low-grade from high-grade bladder cancer. Radiomics could be a reliable method for quantitative assessment of the muscle invasion of bladder cancer.
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Tawfeek A, Mostafa D, Mahmoud M, Radwan A, Hamza I. The role of 3-dimensional sonography and virtual sonographic cystscopy in detection of bladder tumors. AFRICAN JOURNAL OF UROLOGY 2018. [DOI: 10.1016/j.afju.2017.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Computed tomography virtual cystoscopy for follow-up of patients with superficial bladder tumours in comparison to conventional cystoscopy: An exploratory study. Arab J Urol 2016; 14:192-7. [PMID: 27547459 PMCID: PMC4983164 DOI: 10.1016/j.aju.2016.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/18/2016] [Accepted: 06/08/2016] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate and analyse the efficacy of computed tomography (CT) virtual cystoscopy in comparison to conventional cystoscopy for the follow-up of patients with non-muscle-invasive bladder cancer. Patients and methods The study was done over 3 years, from April 2010 to June 2013, and included 30 patients who all had non-muscle-invasive transitional cell carcinoma (Ta, T1). The patients all underwent complete transurethral resection of the tumour and presented for first follow-up check cystoscopy. The examination was performed using a 16-slice multi-detector (MD) CT scanner. The results were compared for sensitivity and specificity in relation to the site, size, and shape of the tumour. Results In all, 20 lesions were detected by CT virtual cystoscopy in 18 patients, whilst the remaining 12 were lesion free. Conventional cystoscopy, detected 23 lesions in 19 patients. The sensitivity of the virtual images was 87%; its specificity in identifying lesions was 100%, with a positive predictive value of 100% and negative predictive value of 78.5%. Conclusion CT virtual cystoscopy is a promising technique for detecting bladder tumours and some other bladder lesions. However, the detection rate for recurrent NMIBC does not appear to be adequate to replace conventional cystoscopy.
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Can CT Virtual Cystoscopy Replace Conventional Cystoscopy in Early Detection of Bladder Cancer? Adv Urol 2015; 2015:926590. [PMID: 26600802 PMCID: PMC4639634 DOI: 10.1155/2015/926590] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 10/11/2015] [Indexed: 12/04/2022] Open
Abstract
Aim. To correlate findings of conventional cystoscopy with CT virtual cystoscopy (CTVC) in detecting bladder tumors and to evaluate accuracy of virtual cystoscopy in early detection of bladder cancer. Material and Method. From June 2013 to June 2014, 50 patients (46 males, four females) with history and investigations suggestive of urothelial cancer, with mean age 62.76 ± 10.45 years, underwent CTVC by a radiologist as per protocol and subsequently underwent conventional cystoscopy (CPE) the same day or the next day. One urologist and one radiologist, blinded to the findings of conventional cystoscopy, independently interpreted the images, and any discrepant readings were resolved with consensus. Result. CTVC detected 23 out of 25 patients with bladder tumor(s) correctly. Two patients were falsely detected as negative while two were falsely labeled as positive in CTVC. Virtual and conventional cystoscopy were comparable in detection of tumor growth in urinary bladder. The sensitivity, specificity, positive predictive value, and negative predictive value of virtual cystoscopy were 92% each. Conclusion. CTVC correlates closely with the findings of conventional cystoscopy. Bladder should be adequately distended and devoid of urine at the time of procedure. However, more studies are required to define the role of virtual cystoscopy in routine clinical practice.
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Role of multidetector computed tomography virtual cystoscopy in evaluation of urinary bladder carcinoma. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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The Role of Virtual Cystoscopy, after Multidetector Computed Tomography Imaging Reconstruction without the Use of Contrast Medium, in the Diagnosis and Evaluations of Bladder Tumors: Preliminary Study. Adv Urol 2014; 2014:923958. [PMID: 24799894 PMCID: PMC3996888 DOI: 10.1155/2014/923958] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 03/09/2014] [Indexed: 12/01/2022] Open
Abstract
Introduction. Although conventional cystoscopy is considered to be the gold standard for diagnosis and follow-up of bladder tumors, it remains an invasive and costly procedure. With the advent of the multidetector CT (MDCT) scanners supported by specialized software virtual cystoscopy (VC) is possible. We assess the role of VC in diagnosing and evaluating bladder lesions. Materials and Methods. Between September 2010 and October 2011, 25 consecutive patients with cystoscopically confirmed bladder tumor underwent VC. The radiologists involved in this prospective study were blinded to the exact findings. After draining any residual urine with a catheter, the bladder was retrogradely insufflated with 200–600 cc of air. No intravenous or intravesical contrast was used. MDCT scan was performed in supine and prone positions and three-dimensional reconstruction of the urinary bladder was performed. Results. The examination was well tolerated by all patients with no complications. In total, 43 lesions were detected both with conventional cystoscopy and VC. Tumor size measured by CT ranged from 3 to 80 mm in diameter. The pathological report revealed noninvasive transitional cell carcinomas in all cases. Conclusion. VC has promising results in detecting exophytic bladder lesions. In the future it could be part of the diagnostic algorithm for bladder tumors.
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Shi Z, Yang Z, Zhang G, Cui G, Xiong X, Liang Z, Lu H. Characterization of texture features of bladder carcinoma and the bladder wall on MRI: initial experience. Acad Radiol 2013; 20:930-8. [PMID: 23830600 PMCID: PMC3734945 DOI: 10.1016/j.acra.2013.03.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 03/18/2013] [Accepted: 03/19/2013] [Indexed: 11/26/2022]
Abstract
RATIONALE AND OBJECTIVES The purpose of this study was to determine textural features that show a significant difference between carcinomatous tissue and the bladder wall on magnetic resonance imaging (MRI) and explore the feasibility of using them to differentiate malignancy from the normal bladder wall as an initial step for establishing MRI as a screening modality for the noninvasive diagnosis of bladder cancer. MATERIALS AND METHODS Regions of interest (ROIs) were manually placed on foci of bladder cancer and uninvolved bladder wall in 22 patients and on the normal bladder wall of 23 volunteers to calculate 40 known textural features. Statistical analysis was applied to determine the difference in these features in bladder cancer versus uninvolved bladder wall versus normal bladder wall of volunteers. The significantly different features were then analyzed using a support vector machine (SVM) classifier to determine their accuracy in differentiating malignancy from the bladder wall. RESULTS Thirty-three of 40 features show significant differences between bladder cancer and the bladder wall. Nine of 40 features were significantly different in uninvolved bladder wall of patients versus normal bladder wall of volunteers. Further study indicates that seven of these 33 features were significantly different between uninvolved bladder wall of patients with early cancer and that of volunteers, whereas 15 of 33 features were different between that of patients with advanced cancer and normal wall. With the testing dataset consisting of ROIs acquired from patients, the classification accuracy using 33 textural features fed into the SVM classifier was 86.97%. CONCLUSION The initial experience demonstrates that texture features are sensitive to reveal the differences between bladder cancer and the bladder wall on MRI. The different features can be used to develop a computer-aided system for the evaluation of the entire bladder wall.
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Affiliation(s)
- Zhengxing Shi
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, 710032, China
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Li QY, Tang J, He EH, Li YM, Zhou Y, Zhang X, Chen G. Clinical utility of three-dimensional contrast-enhanced ultrasound in the differentiation between noninvasive and invasive neoplasms of urinary bladder. Eur J Radiol 2012; 81:2936-42. [DOI: 10.1016/j.ejrad.2011.12.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2011] [Revised: 12/04/2011] [Accepted: 12/05/2011] [Indexed: 01/08/2023]
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Singh I, Mehrotra G, Jaura MS, Agarwal V, Tandon A, Joshi M. Virtual cystoscopy (pneumo-cystoscopy)-Its utility in the prospective evaluation of bladder tumor. Indian J Urol 2012; 28:164-8. [PMID: 22919131 PMCID: PMC3424892 DOI: 10.4103/0970-1591.98457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Aim: To evaluate the role of virtual cystoscopy (VC) comparing it with cystopanendoscopy (CPE) for detecting bladder tumor(s). Material and Methods: Ethical clearance was obtained from the Institutional ethics committee. After an informed consent 30 patients fulfilling the inclusion criteria were enrolled in the prospective non-randomized clinical study and were evaluated as per protocol with VC performed by a qualified radiologist who was blinded to the findings of CPE performed by a qualified urologist. The results so obtained were analyzed using appropriate statistical tools. Results: The mean age of the patients was 56 years. Sensitivity of VC in detecting bladder lesions was 92%. However, when axial images were also interpreted along with VC, the sensitivity increased to 96% for detecting bladder lesions. The specificity of VC with axial CT was 40% in respect of detecting bladder lesions. VC with axial CT was 85.7% sensitive in identifying multiple bladder tumors. There were no complications on account of performing VC. Minor problems were encountered with VC and CPE in 16.7% and 13.3% patients respectively. Conclusions: VC with axial CT is 96% sensitive in detecting bladder lesions and 85.7% sensitive in detecting the multiplicity of the tumors. VC may be a useful complementary diagnostic tool for the workup of select patients with suspected bladder lesions. However, larger randomized controlled studies are needed to better define the precise clinical and diagnostic role of VC in routine practice. Settings and Design: Prospective Clinical Comparative Non Randomized Clinical Study.
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Affiliation(s)
- Iqbal Singh
- Department of Surgery (Div of Urology), University College of Medical Sciences (University of Delhi) and GTB Hospital, Delhi, India
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Tumeurs de vessie intradiverticulaires : revue du Comité de cancérologie de l’Association française d’urologie. Prog Urol 2012; 22:495-502. [DOI: 10.1016/j.purol.2012.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 03/02/2012] [Accepted: 03/26/2012] [Indexed: 11/23/2022]
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Silva-Ramos M, Louro N, Versos R, Cavadas V, Marcelo F. Does 3D Ultrasound Enhance the Diagnosis of Bladder Tumours in Patients with Haematuria? ISRN UROLOGY 2012; 2012:158437. [PMID: 22550603 PMCID: PMC3329719 DOI: 10.5402/2012/158437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 12/22/2011] [Indexed: 12/13/2022]
Abstract
Purpose. Bladder cancer is a frequent cause of haematuria in elderly patients, and bladder ultrasound (US) is a valuable tool in diagnosing these malignancies. We examined the accuracy of 3D bladder US in diagnosing bladder tumors in patients with haematuria. Patients and Methods. Twenty-one patients observed in the emergency department for haematuria underwent a kidney and bladder US. Patients with normal or uncertain bladder US findings underwent a 3D US and a cystoscopy. Results. In 5 (23.8%) patients, the 3D US detected bladder tumours not seen in 2D US. All these patients were found to have bladder tumours on cystoscopy. Another 5 (23.8%) patients with uncertain findings on 2D US had normal 3D US and cystoscopy. 3D US showed a sensitivity of 83.3% and a specificity of 100% with a positive predicted value and negative predictive values of 100% and 93.8%, respectively. Conclusion. 3D US was more sensitive than 2D US in diagnosing bladder tumours in patients with haematuria.
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Affiliation(s)
- Miguel Silva-Ramos
- Department of Urology, Hospital Geral de Santo António, CHP, 4099-001 Porto, Portugal
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Qu X, Huang X, Wu L, Huang G, Ping X, Yan W. Comparison of virtual cystoscopy and ultrasonography for bladder cancer detection: a meta-analysis. Eur J Radiol 2010; 80:188-97. [PMID: 20452159 DOI: 10.1016/j.ejrad.2010.04.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 03/26/2010] [Accepted: 04/07/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND PURPOSE Bladder cancer is the most commonly diagnosed malignancy in patients presenting with haematuria. Early detection is crucial for improving patient prognosis. We therefore performed a meta-analysis to evaluate and compare the detection validity (sensitivity and specificity) of virtual cystoscopy (VC) and ultrasonography (US). METHODS We searched MEDLINE, EMBASE, PubMed and the Cochrane Library for studies evaluating diagnosis validity of VC and US between January 1966 and December 2009. Meta-analysis methods were used to pool sensitivity and specificity and to construct a summary receiver-operating characteristic (SROC) curve. RESULTS A total of 26 studies that included 3084 patients who fulfilled all of the inclusion criteria were considered for inclusion in the analysis. The pooled sensitivity for bladder cancer detection using CT virtual cystoscopy (CTVC), MR virtual cystoscopy (MRVC) and US was 0.939 (95% CI, 0.919-0.956), 0.908 (95% CI, 0.827-0.959) and 0.779 (95% CI, 0.744-0.812), respectively. The pooled specificity for bladder cancer detection using CTVC, MRVC and US was 0.981 (95% CI, 0.973-0.988), 0.948 (95% CI, 0.884-0.983) and 0.962 (95% CI, 0.953-0.969), respectively. The pooled diagnostic odd ratio (DOR) estimate for CTVC (604.22) were significantly higher than for MRVC (144.35, P<0.001) and US (72.472, P<0.001). CONCLUSION Our results showed that both CTVC and MRVC are better imaging methods for diagnosing bladder cancer than US. CTVC has higher diagnostic value (sensitivity, specificity and DOR) for the detection of bladder cancer than either MRCT or US.
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Affiliation(s)
- Xinhua Qu
- Department of Nuclear Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
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Sixteen-Slice Multidetector Computed Tomographic Virtual Cystoscopy in the Evaluation of a Patient With Suspected Bladder Tumor and History of Bladder Carcinoma Operation. J Comput Assist Tomogr 2009; 33:867-71. [DOI: 10.1097/rct.0b013e318199d6da] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Park HJ, Hong SS, Kim JH, Kwon SB, Kwon KH, Choi DL, Park ST, Chang YW, Hwang JH. Tumor detection and serosal invasion of bladder cancer: role of three-dimensional volumetric reconstructed US. ACTA ACUST UNITED AC 2009; 35:265-70. [PMID: 19444499 DOI: 10.1007/s00261-009-9529-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Accepted: 04/20/2009] [Indexed: 11/29/2022]
Affiliation(s)
- Hyun Jeong Park
- Department of Radiology, Soonchunhyang University Hospital, Seoul, Korea
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Lopes RI, Nogueira L, Albertotti CJ, Takahashi DY, Lopes RN. Comparison of Virtual Cystoscopy and Transabdominal Ultrasonography with Conventional Cystoscopy for Bladder Tumor Detection. J Endourol 2008; 22:1725-9. [PMID: 18657034 DOI: 10.1089/end.2007.0363] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
| | - Lucienne Nogueira
- Sociedade Beneficente de Senhoras Hospital Sírio Libanês, São Paulo, Brazil
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16-MDCT Cystoscopy in the Evaluation of Neoplasms of the Urinary Bladder. AJR Am J Roentgenol 2008; 190:729-35. [DOI: 10.2214/ajr.07.3054] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Nieder AM. Editorial Comment. J Urol 2007. [DOI: 10.1016/j.juro.2007.05.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Alan M. Nieder
- Department of Urology, University of Miami Miller School of Medicine, Miami Beach, Florida
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Affiliation(s)
- Mansi A Saksena
- Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA.
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