Computed tomography-virtual cystoscopy in the evaluation of a bladder mass: Could it replace standard conventional cystoscopy?

OBJECTIVE - To determine the role of computed tomography-virtual cystoscopy (CT-VC) in the detection and evaluation of bladder cancer, compared to standard conventional cystoscopy (CC).

PATIENTS AND METHODS - Twenty-five patients with a clinical presentation of a bladder mass(es) were selected from an outpatient urology clinic between May 2011 and August 2012.

All patients were then assessed using multi-slice CT of the bladder, CT-VC and CC. The results were then compared amongst axial CT images, multiplanar reconstruction (MPR) images, CT-VC and CC, and compared with the pathological results.

RESULTS - Forty lesions were found at CC in the 25 patients. MPR images had a greater sensitivity for detecting small masses of ⩽5 mm, and for identifying the location of the masses, especially basal (100%), than had axial images. The diagnostic results varied significantly (P = 0. 031 and 0. 039) between CC and axial images. The difference was slightly significant (P = 0. 063) for MPR images and was not significant (P = 0. 99) for virtual images.

CONCLUSIONS - Compared to CC, CT-VC was much less invasive, but it was not possible to take a biopsy and provide tissue for histopathology, and it could not depict flat lesions or mucosal colour changes. Therefore, CT-VC could be considered for bladder mapping before CC, in the follow-up of patients with superficial transitional cell carcinoma after transurethral resection of the tumour, in combination with urine cytology, and for patients in whom CC is difficult or contraindicated.

Arab journal of urology. 2013 Aug 23 [Epub]

Ahmed H Gabr, Mohamed Elbadry, Ashraf Elsherief, Ehab R Tawfiek

Urology Department, Minia University, Minia, Egypt. , Urology Department, Minia University, Minia, Egypt. , Radiology Department, Minia University, Minia, Egypt. , Urology Department, Minia University, Minia, Egypt.

PubMed