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Accuracy and factors affecting the outcome of multi-detector computerized tomography urography for bladder tumors in the clinical setting.

Hwang EC, Kim JS, Kim SO, Jung SI, Kang TW, Kwon DD, Park K, Ryu SB, Kim JW, Wan LJ - Korean J Urol (2011)

Bottom Line: Of 143 patients, 50 patients had a history of urothelial carcinomas.In these patients, the sensitivity and specificity of MDCTU were 60.0% and 80.0%, respectively.In 93 patients without previous urothelial carcinomas, the sensitivity and specificity of MDCTU were 86.7% and 96.8%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Chonnam National University Medical School, Gwangju, Korea.

ABSTRACT

Purpose: The objective of this study was to investigate the diagnostic accuracy of multi-detector computerized tomography urography (MDCTU) for the detection of bladder tumors.

Materials and methods: We retrospectively reviewed the medical records of 143 patients who were scanned by use of 64-channel MDCTU and who underwent cystoscopy due to painless hematuria or a clinical suspicion of bladder tumor. We examined the accuracy of MDCTU for the detection of bladder tumors by comparing the results obtained by MDCTU with those obtained by cystoscopy. The associations between tumor characteristics, frequency of transurethral resection (TUR), and bladder volume and detectability of bladder tumors on MDCTU were also analyzed.

Results: Of 143 patients, 50 patients had a history of urothelial carcinomas. In these patients, the sensitivity and specificity of MDCTU were 60.0% and 80.0%, respectively. In 93 patients without previous urothelial carcinomas, the sensitivity and specificity of MDCTU were 86.7% and 96.8%, respectively. Falsely diagnosed cases had a smaller distended bladder volume (p=0.014) and a smaller tumor size (p=0.022) than did true diagnosed cases. The false-negative rate increased when the bladder tumor was located at the bladder neck. In the univariate analysis, the tumor location, size, frequency of TUR, bladder volume, and initial hematuria were associated with detectability by MDCTU (p<0.05).

Conclusions: To improve the accuracy of MDCTU for diagnosing bladder tumors, bladder filling is recommended. Thus, cystoscopy should be considered as a standard diagnostic tool for bladder tumors even in patients with normal MDCTU results, especially in the evaluation of recurrent, bladder neck-located, small, or sessile bladder tumors.

No MeSH data available.


Related in: MedlinePlus

Urothelial carcinomas of the bladder and left distal ureter. (A) Axial 2D and (B) 3D volume rendering (VR) CT urograms obtained during the excretory phase show an 11 mm mass (arrow) near the left ureterovesical junction and a 5 mm mass (arrowhead) in the left distal ureter in a 51-year-old man evaluated for gross hematuria. The masses were also detected during the cystoscopy performed after CT urography.
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Figure 1: Urothelial carcinomas of the bladder and left distal ureter. (A) Axial 2D and (B) 3D volume rendering (VR) CT urograms obtained during the excretory phase show an 11 mm mass (arrow) near the left ureterovesical junction and a 5 mm mass (arrowhead) in the left distal ureter in a 51-year-old man evaluated for gross hematuria. The masses were also detected during the cystoscopy performed after CT urography.

Mentions: CT scanning data of the excretory phase were sent to a workstation (Advantage Windows 4.2; GE Healthcare Technologies). Three-dimensional images with volume rendering (VR) and maximum-intensity-projection (MIP) techniques were reconstructed on the workstation. MDCTU images, including two-dimensional (axial, coronal, and sagittal images) and three-dimensional images, were interpreted by one radiologist (KJW) who was blinded to the clinical data (Fig. 1). The average interpretation time of the MDCTU, including two- and three-dimensional images, was 10 minutes.


Accuracy and factors affecting the outcome of multi-detector computerized tomography urography for bladder tumors in the clinical setting.

Hwang EC, Kim JS, Kim SO, Jung SI, Kang TW, Kwon DD, Park K, Ryu SB, Kim JW, Wan LJ - Korean J Urol (2011)

Urothelial carcinomas of the bladder and left distal ureter. (A) Axial 2D and (B) 3D volume rendering (VR) CT urograms obtained during the excretory phase show an 11 mm mass (arrow) near the left ureterovesical junction and a 5 mm mass (arrowhead) in the left distal ureter in a 51-year-old man evaluated for gross hematuria. The masses were also detected during the cystoscopy performed after CT urography.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3037501&req=5

Figure 1: Urothelial carcinomas of the bladder and left distal ureter. (A) Axial 2D and (B) 3D volume rendering (VR) CT urograms obtained during the excretory phase show an 11 mm mass (arrow) near the left ureterovesical junction and a 5 mm mass (arrowhead) in the left distal ureter in a 51-year-old man evaluated for gross hematuria. The masses were also detected during the cystoscopy performed after CT urography.
Mentions: CT scanning data of the excretory phase were sent to a workstation (Advantage Windows 4.2; GE Healthcare Technologies). Three-dimensional images with volume rendering (VR) and maximum-intensity-projection (MIP) techniques were reconstructed on the workstation. MDCTU images, including two-dimensional (axial, coronal, and sagittal images) and three-dimensional images, were interpreted by one radiologist (KJW) who was blinded to the clinical data (Fig. 1). The average interpretation time of the MDCTU, including two- and three-dimensional images, was 10 minutes.

Bottom Line: Of 143 patients, 50 patients had a history of urothelial carcinomas.In these patients, the sensitivity and specificity of MDCTU were 60.0% and 80.0%, respectively.In 93 patients without previous urothelial carcinomas, the sensitivity and specificity of MDCTU were 86.7% and 96.8%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Chonnam National University Medical School, Gwangju, Korea.

ABSTRACT

Purpose: The objective of this study was to investigate the diagnostic accuracy of multi-detector computerized tomography urography (MDCTU) for the detection of bladder tumors.

Materials and methods: We retrospectively reviewed the medical records of 143 patients who were scanned by use of 64-channel MDCTU and who underwent cystoscopy due to painless hematuria or a clinical suspicion of bladder tumor. We examined the accuracy of MDCTU for the detection of bladder tumors by comparing the results obtained by MDCTU with those obtained by cystoscopy. The associations between tumor characteristics, frequency of transurethral resection (TUR), and bladder volume and detectability of bladder tumors on MDCTU were also analyzed.

Results: Of 143 patients, 50 patients had a history of urothelial carcinomas. In these patients, the sensitivity and specificity of MDCTU were 60.0% and 80.0%, respectively. In 93 patients without previous urothelial carcinomas, the sensitivity and specificity of MDCTU were 86.7% and 96.8%, respectively. Falsely diagnosed cases had a smaller distended bladder volume (p=0.014) and a smaller tumor size (p=0.022) than did true diagnosed cases. The false-negative rate increased when the bladder tumor was located at the bladder neck. In the univariate analysis, the tumor location, size, frequency of TUR, bladder volume, and initial hematuria were associated with detectability by MDCTU (p<0.05).

Conclusions: To improve the accuracy of MDCTU for diagnosing bladder tumors, bladder filling is recommended. Thus, cystoscopy should be considered as a standard diagnostic tool for bladder tumors even in patients with normal MDCTU results, especially in the evaluation of recurrent, bladder neck-located, small, or sessile bladder tumors.

No MeSH data available.


Related in: MedlinePlus