Malin Helenius1, Einar Brekkan2, Pär Dahlman1, Maria Lönnemark1, Anders Magnusson1. 1. a 1 Department of Radiology, Oncology and Radiation Science, Section of Radiology, Uppsala University Hospital , Uppsala, Sweden. 2. b 2 Department of Surgical Sciences, Section of Urology, Uppsala University Hospital , Uppsala, Sweden.
Abstract
OBJECTIVE: Computed tomography urography (CTU) can be used to direct further investigation of patients if the bladder tumour detection rate is high. The aim of this study was to compare a CTU protocol including an enhancement-triggered scan and flexible cystoscopy for detecting bladder tumours. MATERIALS AND METHODS: Patients with gross haematuria undergoing CTU during 2005-2008 were included. For patients younger than 50 years the CTU protocol included unenhanced, enhancement-triggered corticomedullary, and excretory phases. Patients older than 50 years followed the same protocol plus a nephrographic phase. The entire urinary tract was examined in all phases. RESULTS: Of 435 patients, 55 patients were diagnosed with bladder tumour. CTU detected bladder tumour in 48 patients (87%). Five CTU examination reports were false positive. With CTU, sensitivity for finding bladder tumour was 0.87, specificity 0.99, positive predictive value (PPV) 0.91 and negative predictive value (NPV) 0.98. Cystoscopy detected bladder tumour in 48 patients (87%) and had one false-positive finding, resulting in sensitivity of 0.87, specificity 1.0, PPV 0.98 and NPV 0.98. CONCLUSIONS: The detection rate of bladder tumours for the CTU protocol including an enhancement-triggered scan was high and comparable to flexible cystoscopy. Hence, this protocol could be used to assess the bladder as the primary investigation and direct further investigation of the patient.
OBJECTIVE: Computed tomography urography (CTU) can be used to direct further investigation of patients if the bladder tumour detection rate is high. The aim of this study was to compare a CTU protocol including an enhancement-triggered scan and flexible cystoscopy for detecting bladder tumours. MATERIALS AND METHODS:Patients with gross haematuria undergoing CTU during 2005-2008 were included. For patients younger than 50 years the CTU protocol included unenhanced, enhancement-triggered corticomedullary, and excretory phases. Patients older than 50 years followed the same protocol plus a nephrographic phase. The entire urinary tract was examined in all phases. RESULTS: Of 435 patients, 55 patients were diagnosed with bladder tumour. CTU detected bladder tumour in 48 patients (87%). Five CTU examination reports were false positive. With CTU, sensitivity for finding bladder tumour was 0.87, specificity 0.99, positive predictive value (PPV) 0.91 and negative predictive value (NPV) 0.98. Cystoscopy detected bladder tumour in 48 patients (87%) and had one false-positive finding, resulting in sensitivity of 0.87, specificity 1.0, PPV 0.98 and NPV 0.98. CONCLUSIONS: The detection rate of bladder tumours for the CTU protocol including an enhancement-triggered scan was high and comparable to flexible cystoscopy. Hence, this protocol could be used to assess the bladder as the primary investigation and direct further investigation of the patient.
Authors: Christopher J D Wallis; Rashid K Sayyid; Roni Manyevitch; Nathan Perlis; Vinata B Lokeshwar; Neil E Fleshner; Martha K Terris; Matthew E Nielsen; Zachary Klaassen Journal: Can Urol Assoc J Date: 2021-02 Impact factor: 1.862
Authors: Rima S Al Johi; Gehan S Seifeldein; Ahmed M Moeen; Noha A Aboulhagag; Ehab M Moussa; Diaa A Hameed; Hisham M Imam Journal: Cent European J Urol Date: 2017-01-16
Authors: Mi Ah Han; Philipp Maisch; Jae Hung Jung; Jun Eul Hwang; Vikram Narayan; Anne Cleves; Eu Chang Hwang; Philipp Dahm Journal: Cochrane Database Syst Rev Date: 2021-06-14