Archive for the ONCOLOGY

CONVENTIONAL AND VIRTUAL CYSTOSCOPIES FOR DIAGNOSIS OF URINARY BLADDER GROWTH LESIONS: A SUPPLEMENTARY RATHER THAN COMPETITIVE RULES

HOSSAM IBRAHIM, ABDUL NASER GHAREEB, MOKHTAR RAGAB  AND EMADELDEEN ALI SALAH*
Radiology and urology* Departments, Al-Azhar University Hospitals, Cairo and Assiut*.

Introduction and aim of the work: Recent CT scan technology allowed three dimensional image reconstructions to precisely and accurately show fine anatomical details. The goal of this study was to evaluate the usefulness of virtual cystoscopy (VC) in diagnosis of urinary bladder neoplasm in comparison with the gold standard conventional cystoscopy (CC).

Patients and Methods: Eighty three consecutive patients (mean age 54 years) clinically presenting for gross haematuria and positive urine cytology for malignancy, were prospectively evaluated with VC after bladder air insufflation or intravenous injection of contrast medium using multi-detector helical CT (1-mm section thickness). Afterwards, all patients had been subjected to CC and examination under anaesthesia.

Results: The findings of VCs were quite comparable with the findings from the CCs except in three patients were not detected by VC (two patients with tumor sizes < 3 mm and one with carcinoma in situ). The bladders of seven patients appeared normal on both CC and VC. The sensitivity and specificity of identification of bladder mass lesions using VC were 96% and 100% respectively, while, it’s positive and negative predictive values were 100%, and 70% respectively.

Conclusion: CT virtual cystoscopy is a minimally invasive technique that could be successfully used for detection of bladder tumors ≥3 mm especially for follow up after transurethral resection of bladder tumors (TURT) cases during daily routine abdominopelvic CT work. It is not a substitute but rather supplementary to CC.


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