Noninvasive ultrasound in detecting and staging bladder carcinoma

Denkhaus, H.; Crone-Münzebrock, W; Huland, H.

doi:10.1007/bf02926870

Cited by 28 publications

(15 citation statements)

References 19 publications

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“…Especially in invasive tumors, endourologic biopsy and resection often miss the true extend in about 50% of the cases [6], CT demonstrated its limitations in staging accuracy, especially in tumors located at bladder dome or trigone. The differentiation between tumors from Ta to T3a is quite uncertain and does not differ significantly from the results obtained by ultrasound (combined suprapubic and intravesical sonography [1,7]. Nevertheless, accu racy rates of 35-92% have been reported [2,[8][9][10], The discrepancy between various reports on staging accuracy of CT may be explained by the different definitions of this term: several authors resume all tumors between Ta and T3a in one group -in contrast to others who try to differentiate between superficial or bladder wall invasive tumors.…”

Section: Discussionmentioning

confidence: 76%

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Gadolinium-Enhanced Magnetic Resonance Imaging in the Staging of Urinary Bladder Neoplasms

Sohn¹,

Neuerburg

Teufl

et al. 1990

Urol Int

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Magnetic resonance imaging (MRI) proved to be an important diagnostic tool in the correct staging of bladder neoplasms. The advantage of multiplane imaging and high soft-tissue contrast may be extended by the use of MRI contrast media such as the gadoliniumdiethylene-triaminepentaacetic acid complex. In 60 patients with suspected or proved bladder tumors, the results of preoperative gadolinium-enhanced MRI were correlated with the histopathologic findings. The staging accuracy of infiltrating tumors was 83% and sensitivity and specificity 86% and 83%, respectively. Three tumors could only be localized after administration of gadolinium. All active tumors demonstrated significant contrast enhancement after intravenously injected gadolinium. Small papillary tumors or carcinoma in situ remain problematic to preoperative staging procedures. The advantages of gadolinium-enhanced MRI will best be employed in the exact pretherapeutic staging of infiltrative bladder neoplasms or in restaging procedures after chemotherapy and radiotherapy.

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Section: Discussionmentioning

confidence: 76%

“…Clinical staging of bladder tumors by means of bi manual palpation, excretory urography, cystoscopy, and biopsy underestimates the tumor category in 10-20% of superficial and in 40-50% of invasive tumors [1]. Even the value of computed tomography (CT) and sonography is limited in differentiating superficial from invasive neoplasms.…”

Section: Introductionmentioning

confidence: 99%

Gadolinium-Enhanced Magnetic Resonance Imaging in the Staging of Urinary Bladder Neoplasms

Sohn¹,

Neuerburg

Teufl

et al. 1990

Urol Int

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“…Of the new imaging techniques available, ultrasonography is easy to use and harmless. Good results (80% accuracy) are obtained with the transabdominal suprapubic approach (McLaughlin et al, 1975;Denkhaus et al, 1985) only when ideal examining conditions are fulfilled. These are the absence of clots, stones, obesity or reduction of bladder capacity.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging in the Staging of Bladder Cancer

Persad

Kabala

Gillatt

et al. 1993

British Journal of Urology

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Magnetic resonance imaging (MRI) scans were performed on 55 bladder cancer patients on whom clinicopathological staging was available from transurethral resection and cystectomy specimens. The overall accuracy of MRI scanning in this group was 84%, although true concordance rates are debatable without open surgical correlation. In the subgroup of 25 patients who had accurate open surgical correlation (from cystectomy, laparotomy or post mortem) the concordance rate was 76% with MRI. Errors occurred mainly in the T3 group of tumours, with 2 being overstaged and 2 being understaged out of a total of 12 in the open surgical correlation group (66% accuracy). Difficulties were also encountered in staging tumours at the bladder base, with an error rate of 22% (2 of 9) for T4 tumours in this area. With regard to lymph node staging there was a 100% (5 of 5) specificity in defining pathologically involved nodes but there was a false negative rate of 15% (3 of 19). Although it has many advantages over CT scanning, MRI produces a significant error rate in terms of over- and under-staging invasive tumours. There are difficulties associated with detecting minimal involvement of adjacent organs and lymph nodes as well as determining the exact depth of muscle penetration. Improvements may come in the future with the use of contrast enhancement agents such as gadolinium as well as more advanced machines.

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“…Its accuracy in staging of carcinoma of bladder ranges from 40 to 92% [14] due to limitations in identifying the depth of tumor penetration and assessing pelvic lymph nodes. Accuracies in the order of 80% [15] have been claimed for staging bladder carcinoma by ultrasound performed endoscopically.…”

Section: Introductionmentioning

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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Noninvasive ultrasound in detecting and staging bladder carcinoma

Cited by 28 publications

References 19 publications

Gadolinium-Enhanced Magnetic Resonance Imaging in the Staging of Urinary Bladder Neoplasms

Gadolinium-Enhanced Magnetic Resonance Imaging in the Staging of Urinary Bladder Neoplasms

Magnetic Resonance Imaging in the Staging of Bladder Cancer

Staging of Bladder Carcinoma: MRI—Pathologic Correlation

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