Virtual cystoscopy based on helical CT scan datasets: perspectives and limitations.

Abstract

The purpose of the study was to simulate cystoscopy based on three-dimensional helical CT scan datasets in real-time in patients with tumours of the urinary bladder. A helical CT scan with double detector technology was carried out pre-operatively in 11 patients with histologically confirmed carcinoma of the urinary bladder and one patient with chronic cystitis. A non-enhanced scan was first performed, followed by an examination in the early phase of contrast medium enhancement. Further images were acquired after adequate filling of the bladder with contrast medium, approximately 30 min after injection. These data were transferred to a separate graphic computer workstation and reconstructed. The results were then compared with the cystoscopic and histopathological findings. All tumours of the urinary bladder identified at fibreoptic cystoscopy were shown on virtual cystoscopy. The best reconstruction results were obtained from data acquired 30 min after injection of contrast medium. The ureteric orifices were not visualized at virtual cystoscopy. These data lead us to conclude that, at present, virtual cystoscopy has not reached the quality of fibreoptic examination and remains restricted to use in specific cases, for example patients with urethral strictures.

Diagnostic Efficiency of Multidetector Computed Tomography With Multiplanar Reformatted Imaging and Virtual Cystoscopy in the Assessment of Bladder Tumors After Transurethral Resection

“…This technique, first used by Merkle et al, 18 is a minimally invasive method. It can be carried out as a component of routine abdominopelvic CT investigation with contrast.…”

Urological Surgical Procedures Under Local Anesthesia

“…In phase III trial, there was one case of bladder cancer that was detected by HAL fluorescence cystoscopy that was missed by white light cystoscopy (Grossman et al, 2007). Study on efficacy of virtual cystoscopy in patients with bladder tumors shows that its use is still in its infancy and has not yet reached the acceptable quality of fibreoptic examination (Merkle et al, 1998). Yet another study found that in comparison with standard cystoscopy, narrow-band imaging could better detect "nonmuscle-invasive bladder tumors" (Herr and Donat, 2008).…”

Die virtuelle Endoskopie des Harntrakts

“…Ebenso ist es möglich, jodhaltiges Kontrastmittel i.v. zu verabreichen, und die Füllung der Blase mit kontrastiertem Urin abzuwarten [16]. Dies hat den Vorteil, keinen Blasenkatheter legen zu müssen, birgt aber das geringe Risiko einer Unverträglichkeitsreaktion auf jodhaltiges Kontrastmittel.…”