Reliability of CT in Preoperative Evaluation of Bladder Carcinoma

Abstract

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.

Nuclear Medicine Studies of the Prostate, Testes, and Bladder

“…CT scanning can detect only gross tumor extension beyond the bladder wall with an accuracy of 64 to 92%. 202 The accuracy of CT in detecting lymph node metastases ranges from 70 to 90% with false-negative rates as high as 40%. 203 Similarly, MRI has been disappointing with regard to staging, with accuracies ranging from 60 to 75%.…”

Imaging in genitourinary cancer from the urologists��������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� perspective

“…As it is rare for metastases to be associated with superficial disease, MRI and CT are used for assessing the presence of metastases in patients with documented muscle-invasive bladder cancer [116] . However, the accuracy of MRI and CT for lymph node staging ranges from 70% to 98%, with a false-negative rate of 20–40% [114,116,117] . Currently, the preferred method for accurate N-staging still remains pelvic lympadenectomy.…”

Positron Emission Tomography in Urologic Oncology

“…CT scanning can detect only gross tumor extension beyond the bladder wall with an accuracy of 64% to 92%. 21 In addition, its accuracy in detecting lymph node metastasis ranges from 70% to 90% with false-negative rates as high as 40%. 22 Similarly, magnetic resonance imaging (MRI) has been disappointing with regard to staging, with accuracies ranging from 60% to 75%.…”

“…Both of these imaging modalities have been found to have a propensity for overstaging because their findings are based on anatomical changes that may not correlate with malignancy. 21,24 Given the ability of PET to detect differential metabol-ic activity, investigators began exploring the use of PET to stage bladder cancer.…”