Virtual computed tomography cystoscopy in bladder pathologies

Abstract

Objective: Assessed the usefulness of virtual cystoscopy performed with multidetector computed tomography (CT) in patients with different urinary bladder pathologies compared to the conventional cystoscopy. Materials and Methods: Eighteen patients with different bladder pathologies, which consisted of 11 tumors, 3 diverticula, 2 trabecular changes and 2 stones, were assessed with conventional cystoscopy and virtual CT cystoscopy. The results of virtual CT cystoscopy were compared with the findings of conventional cystoscopy. We determined the detection rate and positive predictive value of CT imaging based virtual cystoscopy in the diagnosis of urinary bladder lesions. Results: CT scanning was well tolerated by all patients, and no complications occurred. Images in 16 (88%) of the 18 virtual cystoscopic examinations were either of excellent or good quality. All tumors except one, 2 trabecular changes and 2 stones were characterized with similar findings in the both of methods. The masses ranged from 0.4 to 7.0 cm in diameter. While conventional cystoscopy could not evaluate interior part of the diverticulum, virtual CT cystoscopy could demonstrate clearly within it. There were no false-positive findings in our series. Conclusion: Virtual CT cystoscopy is a promising technique to be used in the detection of bladder lesions. It should be considered especially at the evaluation of bladder diverticula. In the future, it may be possible or even advantageous to incorporate into the imaging algorithm for evaluation of bladder lesion.

Bladder Cancer in 2010: How Far have We Come?

“…38 The advantages of virtual cystoscopy include its minimal invasiveness, the evaluation of the urethral orifice from a cranial view, the visualization of the mucosa within diverticulae, and its use in patients with urethral stricture disease. 40,41 The disadvantages include cost, inability to obtain tissue, low sensitivity to depict flat lesions such as carcinoma in situ (CIS), and increased radiation exposure, specifically with CT cystoscopy. 38,42 CT cystoscopy is performed by insufflating air or carbon dioxide into the bladder; alternatively, bladder distention can be achieved by instilling dilute contrast through a 6-French feeding tube.…”

Comparison of Virtual Cystoscopy and Transabdominal Ultrasonography with Conventional Cystoscopy for Bladder Tumor Detection

“…Presence of tumor, tumor histology, tumor size, site, multiplicity, type, (polypoid versus non-polypoid) and tumor grade (1)(2)(3)(4) were evaluated in all examinations. Subsites, grades, and histologic classifications were those designated by the World Health Organization, as outlined in the International Classification of Diseases for Oncology (ICDO), 1976.…”

“…Clinically, patients with these conditions present with hematuria, dysuria, and voiding symptoms. 1 Today, with routine use of imaging in daily practice to evaluate abdominopelvic, urologic, and gynecologic conditions, incidental tumors comprise a bigger percentage of cases referred to the urologist. Different noninvasive methods are used for diagnosis, with ultrasonography (US) being the most used in daily practice.…”

“…Virtual cystoscopy (VC) has been applied recently to study bladder tumors. [1][2][3][4][5][6][7][8][9] It consists of three-dimensional (3-D) computer-rendering techniques with the possibility of interactive intraluminal navigation through the bladder simulating conventional cystoscopy (CC). CC remains the gold standard for bladder tumor detection and follow-up.…”

“…It has drawbacks, however, such as invasiveness, discomfort to the patient, high costs, iatrogenic injury, and urinary sepsis. [1][2][3][4][5][6][7][8][9] Because some lesions, such as those of bladder cancer, usually recur, necessitating long-term follow-up, an accurate imaging method would help to reduce the number of CC procedures.…”