Detection of Bladder Tumors With 3-Dimensional Sonography and Virtual Sonographic Cystoscopy

Abstract

Objective. Bladder tumors are among the most common types of malignant neoplasms of the urinary tract. The purpose of this study was to evaluate the potential value of 3-dimensional (3D) sonography and sonographic cystoscopy in detection of bladder tumors. Methods. Thirty-one patients with suspected or known bladder tumors were included this study. All patients underwent 3D sonography and conventional cystoscopy within 15 days. The number, size, location, and morphologic features of the lesions were evaluated on gray scale, 3D virtual, and multiplanar reconstruction images obtained from the patients. The results of 3D sonographic cystoscopy were compared with the findings from conventional cystoscopy, which was considered the reference standard. Results. Twenty-eight (90.3%) of 31 3D virtual sonographic cystoscopic studies had good or excellent image quality. Conventional cystoscopy revealed 47 lesions in 22 of 28 patients; 3D sonographic virtual cystoscopy showed 41 (87.2%) of 47 lesions. Three-dimensional virtual sonography alone had sensitivity of 96.2%, specificity of 70.6%, a positive predictive value of 93.9%, and a negative predictive value of 80% for tumor detection. The combination of gray scale sonography, multiplanar reconstruction, and 3D virtual sonography had sensitivity of 96.4%, specificity of 88.8%, a positive predictive value of 97.6%, and a negative predictive value of 84.2% for tumor detection. Conclusions. Three-dimensional sonography is a promising alternative noninvasive technique for use in detection of bladder tumors, their localization, and perivesical spreading. The location, size, and morphologic features of the tumors shown on 3D sonography agreed well with the findings of conventional cystoscopy. Key words: bladder; neoplasm; sonography; 3-dimensional virtual cystoscopy. Radiology (E.K., A.K., A.K.P., H.A.) ladder tumors are among the most common neoplasms of the urinary tract, accounting for 6% of all malignancies in men and 2% of those in women. 1 In the United States, it is the 7th leading cause of cancer death in men and the 10th in women. Received June 25, 2007, from the Departments of2 A patient with a bladder tumor usually has hematuria, and the initial evaluations are a cytologic analysis of urine and cystoscopy with or without a biopsy.3 The role of crosssectional imaging in the initial evaluation of bladder cancer is limited, and computed tomography (CT) and magnetic resonance (MR) imaging are usually performed to evaluate extravesical extension or to stage the tumor. 3,4

Does 3D Ultrasound Enhance the Diagnosis of Bladder Tumours in Patients with Haematuria?

“…In urology, it has been used in planning and guiding prostate cancer treatments [16], to accurately measure bladder volume [17] and in imaging the urethral sphincter in pelvic floor disorders [18]. Recently, the use of 3D US in the evaluation of bladder tumours has been reported showing a moderate-to-perfect interobserver agreement [6]. Wagner et al [19] studied 3D US as a staging tool in distinguishing invasive from noninvasive bladder tumours, showing an overall accuracy of 79%.…”

Prospective evaluation of interobserver diagnostic agreement for focal urinary bladder wall abnormalities detected by ultrasound

“…In addition, further improvements in diagnostic US capabilities for bladder cancer might be expected from introduction of new techologies such as 3D reconstruction [29] and contrast-enhanced US [30].…”

Application of Three-Dimensional Volumetric Ultrasonography in Patients with Bladder Cancer and Its Mimickers: A Pictorial Essay

“…In prior studies, 2-to 5-MHz convex or curvilinear transducers were used (3)(4)(5). Patients were asked to drink about 500 mL to 1000 mL of water and not to void for an hour before the US examination in order to perform it with the bladder fully distended (3, 4).…”