Computed tomography virtual cystoscopy for follow-up of patients with superficial bladder tumours in comparison to conventional cystoscopy: An exploratory study

Hossam Elawady, Mahmoud A Mahmoud, Diaaeldin M A Mostafa, Alaa Abdelmaksoud, Mohamed W Safa, Remon Z Elia, Hossam Elawady, Mahmoud A Mahmoud, Diaaeldin M A Mostafa, Alaa Abdelmaksoud, Mohamed W Safa, Remon Z Elia

Abstract

Objective: To evaluate and analyse the efficacy of computed tomography (CT) virtual cystoscopy in comparison to conventional cystoscopy for the follow-up of patients with non-muscle-invasive bladder cancer.

Patients and methods: The study was done over 3 years, from April 2010 to June 2013, and included 30 patients who all had non-muscle-invasive transitional cell carcinoma (Ta, T1). The patients all underwent complete transurethral resection of the tumour and presented for first follow-up check cystoscopy. The examination was performed using a 16-slice multi-detector (MD) CT scanner. The results were compared for sensitivity and specificity in relation to the site, size, and shape of the tumour.

Results: In all, 20 lesions were detected by CT virtual cystoscopy in 18 patients, whilst the remaining 12 were lesion free. Conventional cystoscopy, detected 23 lesions in 19 patients. The sensitivity of the virtual images was 87%; its specificity in identifying lesions was 100%, with a positive predictive value of 100% and negative predictive value of 78.5%.

Conclusion: CT virtual cystoscopy is a promising technique for detecting bladder tumours and some other bladder lesions. However, the detection rate for recurrent NMIBC does not appear to be adequate to replace conventional cystoscopy.

Keywords: Conventional cystoscopy; MDCT, multi-detector CT; NMIBC, non-muscle-invasive bladder cancer; NPV, negative predictive value; Non-muscle-invasive bladder cancer; PPV, positive predictive value; TURBT, transurethral resection of bladder tumour; Virtual cystoscopy.

Figures

Figure 1
Figure 1
Lesions’ histopathology.
Figure 2
Figure 2
Virtual cystoscopy of a 70-year-old man with two recurrent lesions (TCCs) at first follow-up.
Figure 3
Figure 3
Follow-up CT virtual cystoscopy of a male patient showing a trabeculated bladder and small focal thickening, as shown by the yellow arrow diagnosed as an inflammatory lesion by conventional cystoscopy.
Figure 4
Figure 4
Small lesion detected by CT virtual cystoscopy that was confirmed to be an organised blood clot by conventional cystoscopy.

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Source: PubMed

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