EAU 2018: 4D Ultrasound Cystoscopy with Fly Through in the Evaluation of Urinary Bladder Tumors: Feasibility and Outcomes

Copenhagen, Denmark (UroToday.com)  Dr. Grande and colleagues from Italy discussed their experience with 4D ultrasound cystoscopy with Fly Thru. Cystoscopy represents the gold standard both for the diagnosis and the surveillance of patients treated conservatively for bladder cancer. To date, a reliable, non-invasive, imaging method for bladder cancer detection has yet to be established and follow-up is based on regular cystoscopy. The recently introduced Fly Thru technology virtually travels through a body cavity and produces endoscopic images from outside the body. This provides the opportunity to assess masses and plan for appropriate management. 

4D ultrasound cystoscopy

The objectives of this study were to assess the feasibility and diagnostic efficacy of 4D ultrasound cystoscopy with Fly Thru as compared with traditional 2D ultrasound and cystoscopy in detecting and characterizing urinary bladder lesions.

For this study, there were 30 consecutive patients between August 2016 and July 2017 with bladder lesions previously detected at cystoscopy who were prospectively evaluated with 2D baseline ultrasound and 4D ultrasound with Fly Thru by an expert radiologist blinded to cystoscopy results. The two imaging modalities were compared with cystoscopy in order to assess the sensitivity and specificity of tumor detection and characterization. The diagnostic performance of 2D features and 4D ultrasound were estimated and compared using ROC curve analysis.

In total, 24/33 (73%) of bladder lesions were detected by 2D ultrasound and 31/33 (94%) by 4D ultrasound, respectively. The 4D ultrasound was also able to identify two more lesions that had not been detected by previous traditional cystoscopy. Additionally, tumor features at ultrasound were consistent with those provided by the cystoscopy, with no significant differences in terms of characterization (p=0.865).

The authors concluded that their preliminary results show that 4D ultrasound cystoscopy with Fly Thru technology is more accurate than baseline 2D ultrasound to detect and characterize bladder lesions with similar results when compared with traditional cystoscopy. Based on the sample size of the current study, larger validation analyses are certainly necessary.

Presented by: Pietro Grande, Sapienza University, Rome, Italy

Co-Authors: Lemma A. 1 , Cristini C. 1 , Cantisani V. 2 , Forte V. 2 , Ciccariello M. 2 , Drudi F. 2 , Catalano C. 2 , D'Ambrosio F. 2 , Di Pierro G.B. 1
Author Information:
1. Sapienza University, Dept. of Obstetrics and Gynaecology Sciences and Urologic Sciences, Rome, Italy
2. Sapienza University, Dept. of Radiological Sciences, Rome, Italy

Written by: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre, twitter: @zklaassen_md at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark