Computed Tomography in Staging of Carcinoma of the Urinary Bladder

Vock, Peter; Haertel, M; Fuchs, W. A.; Karrer, P.; Bishop, M. C.; Zingg, E. J.

doi:10.1111/j.1464-410x.1982.tb13539.x

Cited by 65 publications

(10 citation statements)

References 16 publications

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“…The acc uracy of CT for predi cting lymph node invo lvement has been studied in seri es ranging from 15 to 74 pati ents ( 4,6,12,16) , the d egree of accuracy be ing between 87 % and 99% . Our own experi ence is limited , because fo rmal lymphade nectomy was perfo rmed in only one case o f the present se ri es.…”

Section: Discussionmentioning

confidence: 99%

Reliability of CT in Preoperative Evaluation of Bladder Carcinoma

Nurmi¹,

Katevuo

Puntala³

1988

Scandinavian Journal of Urology and Nephrology

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Sixty patients with bladder carcinoma were examined by CT prior to radical cystectomy. CT indicated perivesical tumour growth or extension to neighbouring organs correctly in 68% of these cases. Overstaging was observed in 23% and understaging in 8% of the cases. Most of the difficulties concerned assessment of tumours in the anterior bladder wall and identification of the plane between the bladder and the seminal vesicle. In most instances CT provided no supplementary information to clinical staging, but was useful when obesity or previous irradiation impeded clinical staging.

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Section: Discussionmentioning

confidence: 99%

Reliability of CT in Preoperative Evaluation of Bladder Carcinoma

Nurmi¹,

Katevuo

Puntala³

1988

Scandinavian Journal of Urology and Nephrology

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“…Therefore, a localized postoperative inflammatory pro cess with thickening of the bladder wall might have led to the misdiagnosis. It is reported [11] that correct iden tification of tumor stages less than Tja is extremely dif ficult in CT, because it cannot accurately distinguish deep muscle invasion from mucosal, submucosal, or superficial muscle invasion. In our series, CT over staged 4 cases as Twhich were correctly staged as T | by MRI except for case 9.…”

Section: Discussionmentioning

confidence: 99%

Staging of Bladder Carcinoma by Magnetic Resonance Imaging

Namiki

Yoshioka²,

Kadota³

et al. 1987

Urol Int

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Magnetic resonance imaging (MRI) of bladder carcinoma was performed in 10 patients who subsequently underwent operations for tumor staging. MRI was performed with a 0.1 T resistive magnetic resonance unit. Images were obtained in the transverse, coronal and sagittal directions with different repetition and echo times. Simultaneously, computed tomography (CT) was performed in 9 of the 10 patients. The accuracy of MRI and CT staging was then evaluated by comparison with the staging from pathologic diagnosis. All of the tumors, which were 2.3–6.3 cm in diameter, were readily depicted by both imaging techniques. The overall accuracy of MRI staging for the 10 patients in whom staging had been pathologically confirmed was 90%, while the accuracy of CT staging for the 9 patients was 55 %. Although no statistically significant differences in accuracy between CT and MRI staging can be established on the basis of the above results because of the small number of patients included in this study, MRI appears to be a very useful modality for staging bladder carcinoma.

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“…Spin echo T 2 -weighted sequences were useful in terms of evaluating the neoplastic infiltration of the bladder wall which appeared as a low signal intensity line, and disruption of the hypointense line was considered as a sign of neoplastic infiltration [3,18,20]. Plain T 1 -weighted sequences were useful to detect extra-vesical tumor involvement, since in case of infiltration the low signal intensity of the tumor replaced the normal high signal intensity of the perivesical fat [21 -23].…”

Section: Diagnostic Criteriamentioning

confidence: 99%

Staging of Bladder Carcinoma: MRI—Pathologic Correlation

et al. 2003

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Objective: To evaluate the accuracy of MR imaging in the staging of bladder carcinoma and to correlate the results with pathological stage.Material and methods: Through patients of newly diagnosed bladder carcinoma with a mean age of 45^9.94 years who were candidates for radical cystectomy were included in the study. Patients with distant metastases or those with past history of malignancy elsewhere were excluded. The clinical stage for each patient was determined from the results of the conventional techniques. To avoid artifacts and edema of the bladder wall, cystoscopy and cold cup biopsy / transurethral resection was performed at best 2 -3 weeks before magnetic resonance imaging (MRI). MRI was performed with a 0.2 tesla permanent magnet system (Sigma 0.2T System GEM SO CO1). Within 3 weeks after MRI all patients underwent radical cystectomy. MRI images were prospectively interpreted by two radiologists and reviewed for consensus by one urologist without knowledge of the final pathological findings obtained after surgery. All patients were treated by retrograde radical cystectomy with either ileal conduit or ureterosigmoidostomy or ileal neobladder. Histopathological evaluation included the determination of the type, grade and stage of the tumor. The tumor was staged as per the tumor-node-metastasis (TNM) system (1997). The pathologic findings were finally correlated with the MRI findings.Results: Extension through the deep muscle of the bladder wall was present in 18 of the 20 patients and was diagnosed with a sensitivity of 94.4% and specificity of 100%. Extension to perivesical fat was present in 11 of 20 patients and was diagnosed with a sensitivity of 82% and a specificity of 100%. Invasion of the adjacent organs was present in 3 of 20 patients and was diagnosed with a sensitivity of 33.3% and a specificity of 100%. On the basis of MR findings, the tumor was correctly staged, according to the TNM staging (1997), in 15 of 20 (75%) patients. Tumor extension was overestimated in 2 of 20 (10%) patients and underestimated in 3 of 20 (15%).Conclusion: In summary, MRI is an accurate non-invasive modality for assessing whether the tumor is confined to or extends beyond the bladder wall. It is superior to clinical staging of T 2b , T 3b and T 4 lesions. It is possible to distinguish T 2a from T 2b lesions involving the full thickness of bladder wall and this may have therapeutic implications.

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Computed Tomography in Staging of Carcinoma of the Urinary Bladder

Cited by 65 publications

References 16 publications

Reliability of CT in Preoperative Evaluation of Bladder Carcinoma

Reliability of CT in Preoperative Evaluation of Bladder Carcinoma

Staging of Bladder Carcinoma by Magnetic Resonance Imaging

Staging of Bladder Carcinoma: MRI—Pathologic Correlation

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