Bladder Cancer Diagnosis: The Role of CT Urography

Capalbo, Emanuela; Kluzer, A.; Peli, Michela; Cosentino, Marı́a José; Berti, Elisabetta; Cariati, Maurizio

doi:10.5301/tj.5000331

Cited by 15 publications

(5 citation statements)

References 27 publications

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“…Cystoscopy alone has been advocated based on the observation that GU tumors associated with AMH are predominantly located in the lower urinary tract, whereas upper tract tumors comprise just 5% of all urothelial neoplasms . Computed tomographic urography alone has been advocated on the basis of improved sensitivity and specificity of modern CT for detection of lower urinary tract cancers, thereby obviating the need for and sparing the morbidity of cystoscopy . We did not evaluate ultrasound alone owing to the low sensitivity of ultrasound for detection of lower tract malignant abnormalities, which accounts for the majority of GU malignant abnormalities in patients with AMH, thereby rendering ultrasound alone a poor strategy for initial detection of malignant abnormalities in this population …”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of Common Diagnostic Approaches for Evaluation of Asymptomatic Microscopic Hematuria

2017

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IMPORTANCE Asymptomatic microscopic hematuria (AMH) is highly prevalent and may signal occult genitourinary (GU) malignant abnormality. Common diagnostic approaches differ in their costs and effectiveness in detecting cancer. Given the low prevalence of GU malignant abnormality among patients with AMH, it is important to quantify the cost implications of detecting cancer for each approach. OBJECTIVE To estimate the effectiveness, costs, and incremental cost per cancer detected (ICCD) for 4 common diagnostic approaches evaluating AMH. DESIGN, SETTING, AND PARTICIPANTS A decision-analytic model-based cost-effectiveness analysis using inputs from the medical literature. PubMed searches were performed to identify relevant literature for all key model inputs, each of which was derived from the clinical study with the most robust data and greatest applicability. Analysis included adult patients with AMH on routine urinalysis with subgroups of high-risk patients (males, smokers, age Ն50 years) seen in the primary care or urologic referral setting. INTERVENTIONS Four diagnostic approaches were evaluated relative to the reference case of no evaluation: (1) computed tomography (CT) alone; (2) cystoscopy alone; (3) CT and cystoscopy combined; and (4) renal ultrasound and cystoscopy combined. MAIN OUTCOMES AND MEASURES At termination of the diagnostic period, cancers detected, costs (payer perspective), and ICCD per 10 000 patients evaluated for AMH. RESULTS Of the 4 diagnostic approaches analyzed, CT alone was dominated by all other strategies, detecting 221 cancers at a cost of $9 300 000. Ultrasound and cystoscopy detected 245 cancers and was most cost-effective with an ICCD of $53 810. Replacing ultrasound with CT detected just 1 additional cancer at an ICCD of $6 480 484. Ultrasound and cystoscopy remained the most cost-effective approach in subgroup analysis. The model was not sensitive to any inputs within the proposed ranges. Using probabilistic sensitivity analysis, ultrasound and cystoscopy was the dominant strategy in 100% of simulations. CONCLUSIONS AND RELEVANCE The combination of renal ultrasound and cystoscopy is the most cost-effective among 4 diagnostic approaches for the initial evaluation of AMH. The use of ultrasound in lieu of CT as the first-line diagnostic strategy will optimize cancer detection and reduce costs associated with evaluation of AMH. Given our findings, we need to critically evaluate the appropriateness of our current clinical practices, and potentially alter our guidelines to reflect the most effective screening strategies for patients with AMH.

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Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of Common Diagnostic Approaches for Evaluation of Asymptomatic Microscopic Hematuria

2017

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“…The sensitivity and specificity of CTU in detection of primary bladder cancer in patients with no history of urothelial cancer vary between 79.4% and 100% and 83% and 99%, respectively. 28,[37][38][39][40][41][42][43] Lower sensitivities for CTU were reported in patients with a history of urothelial cancer. 38,43 Computed tomography urography has a higher sensitivity for detection of bladder cancer in patients with macroscopic hematuria (83.3%) as opposed to microscopic hematuria (42.3%).…”

Section: Computed Tomography Of Urinary Bladder Cancermentioning

confidence: 97%

Section: Imaging Evaluationmentioning

confidence: 99%

Radiologic Diagnosis and Staging of Bladder Cancer: An Update

Awiwi¹,

Vikram²

2022

J Comput Assist Tomogr

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Although cystoscopic biopsy is the standard of care for initial diagnosis and local staging of bladder cancer, radiologic imaging plays a major role in identifying local invasion, nodal status, distant metastasis, and posttreatment surveillance. Recent development of the Vesical Imaging-Reporting and Data System for interpretation of multiparametric magnetic resonance imaging of the bladder has expanded the role diagnostic imaging in the management of bladder cancer. This article reviews multimodality imaging appearances, staging, and differential diagnosis of bladder cancer.

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“…Trong nghiên cứu của chúng tôi, các khối u đều được phát hiện trên XQCLVT, đa phần các khối u sẽ được phát hiện trong thì động mạch đơn độc hoặc kết hợp với thì tĩnh mạch và thì muộn, khoảng 2,1% khối u chỉ phát hiện được trên duy nhất thì muộn. Kết quả này phù hợp với nghiên cứu của tác giả Capalbo và cộng sự (2015) [5] với tỷ lệ lần lượt là 93,4% và 6,6%. Cùng với kết quả của sự ngấm thuốc u bàng quang 70% ngấm thuốc mạnh, 29% ngấm thuốc vừa.…”

Section: Bàn Luận 41 Dấu Hiệu Phát Hiện U Và Ngấm Thuốc Của U Trên Xq...unclassified

Đặc điểm hình ảnh ung thư bàng quang trên Xquang cắt lớp vi tính

Bùi Thị Thanh,

Lâm Diễm,

Huỳnh Quang

2022

PNTJMP

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- Đặt vấn đề: Ung thư bàng quang (UTBQ) là bệnh lý ác tính thường gặp ở cơ quan tiết niệu sinh dục. Với sự tiến bộ không ngừng của chẩn đoán hình ảnh và thăm dò chức năng, ung thư bàng quang ngày càng được chẩn đoán sớm và chính xác. Đề tài này nhằm mô tả đặc điểm hình ảnh trên XQuang cắt lớp vi tính (XQCLVT) của ung thư bàng quang. - Phương pháp: Nghiên cứu hồi cứu 194 bệnh nhân UTBQ được điều trị phẫu thuật tại Bệnh viện Bình Dân thời gian từ tháng 01 năm 2020 đến hết tháng 06 năm 2020. Trước phẫu thuật được chụp XQCLVT 16 hoặc 64 dãy. - Kết quả: UTBQ hay gặp ở thành bên và thành sau, với đại thể là khối u thể chồi sùi, chân hẹp 84%. Kích thước của khối u trung bình là 30,7 ± 18,1 mm, hay gặp khối u có kích thước từ 11 - 50mm chiếm tỷ lệ 71,7%. Các khối u bàng quang thường được phát hiện trên trong thì động mạch đơn độc hoặc kết hợp với thì tĩnh mạch và thì bài xuất, với tính chất bắt thuốc mạnh (70%), tạo hình khuyết thuốc trong thì bài xuất. Abstract - Background: Bladder cancer is a common malignancy in the urogenital organs. With the advancement of imaging modalities, bladder cancer is increasingly being diagnosed early and accurately. This study aims to character the images of computed tomography (CT) in bladder cancer. - Methods: A retrospective study was conducted on 194 bladder cancer patients who underwent operation at Binh Dan Hospital from January 2020 to June 2020. All patients were preoperatively performed an CT scan. - Results: Tumors are common in the lateral and posterior walls, with a macroscopic tumor of the bud with a narrow base 84%. The average size of the tumor was 30.7 ± 18.1 mm, the tumor size from 11 to 50mm was common, accounting for 71.7%. Bladder tumors are usually detected in the phase.

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Bladder Cancer Diagnosis: The Role of CT Urography

Abstract: Computed tomography urography is an accurate examination for the diagnosis of bladder cancer, and the arterial acquisition phase provides the best diagnostic information.

Cited by 15 publications

References 27 publications

Cost-effectiveness of Common Diagnostic Approaches for Evaluation of Asymptomatic Microscopic Hematuria

Cost-effectiveness of Common Diagnostic Approaches for Evaluation of Asymptomatic Microscopic Hematuria

Radiologic Diagnosis and Staging of Bladder Cancer: An Update

Đặc điểm hình ảnh ung thư bàng quang trên Xquang cắt lớp vi tính

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