Usefulness of transabdominal ultrasound, computed tomography and nuclear resonance imaging for clinical staging of muscle invasive bladder cancer in radical cystectomy patients
Article published in Urologia Polska 2004/57/2.
Piotr Chłosta 1, Artur A. Antoniewicz 2, Tomasz Szopiński 2, Grzegorz Kata 2, Radosław Jardanowski 2, Cezary Szcze¶niak 2, Andrzej Borówka 2
- 1 Oddział Urologii Szpitala Specjalistycznego z Przychodnią EMC we Wrocławiu
Ordynator oddziału: dr med. Piotr Chłosta, FEBU
2 Zespół Dydaktyki Urologicznej CMKP, Oddział Urologii Centralnego Szpitala Kolejowego w Warszawie
Ordynator oddziału i kierownik zespołu: prof. dr hab. Andrzej Borówka
bladder, transabdominal USG, computed tomography, nuclear magnetic resonance, bladder cancer, radical cystectomy
- The treatment method of the bladder cancer depends on clinical staging of the tumour. Radical cystectomy is the treatment of choice in invasive bladder cancer. Preoperative clinical staging of the tumour is based on complex analysis of the results gained from diagnostics methods.
- Comparison of usefulness of transabdominal ultrasound (TAUS), computed tomography (CT) and nuclear resonance (NMR) imaging for clinical staging of muscle invasive bladder cancer in radical cystectomy patients
- material and methods
- 72 patients were analysed, aged from 54 to 68 (mean 62). Radical cystectomy was performed, preceded by transurethral resection of the tumour (TURT), during which tissue samples were obtained for pathology examination which proved the muscle invasive bladder cancer. IVU and TAUS were performed before TURT, and at least 3 weeks later CT and NMR. Immediately after bladder removal it was filled with formaldehyde and immersed into the same solution. After 24 hours the specimen was sliced to get sections comparable to TAUS, CT and NMR pictures as well as to real pathomorphological staging (pT).
- Invasive bladder cancer was found in the stages pT2a, pTb and pT3b in 6, 60 and 6 patients, respectively. The full compatibility of the diagnosis made by TAUS, CT, NMR and real clinical staging obtained by histological examination was found in 12,5% cases: 6 pT2a and 3 pT3b patients. The risk of over- and underestimation was respectively 63-71% and 4-16,5%.
- TAUS, CT and NMR produced the similar risk of overstaging the muscle invasive bladder cancer. The highest risk of underestimating the clinical staging of muscle invasive bladder cancer is connected with TAUS.