Bladder cancer: can imaging change patient management?

Area of Science:

• Urologic oncology
• Medical imaging
• Diagnostic radiology

Background:

• Bladder cancer management has been significantly influenced by recent technological advancements in diagnostic imaging.
• Traditional methods like intravenous pyelography are being superseded by more advanced techniques.

Purpose of the Study:

• To review the impact of recent technical advances on the management of patients with bladder cancer.
• To highlight the evolving role of imaging modalities in diagnosing and staging urothelial cancers.

Main Methods:

• Review of current literature on advanced imaging techniques for bladder cancer.
• Comparison of computed tomography urography (CTU) and magnetic resonance imaging (MRI) in bladder cancer assessment.
• Focus on multislice CT scanners and multiphase CTU protocols.

Main Results:

• Multislice CTU has largely replaced intravenous pyelography for detecting urothelial cancer and identifying causes of hematuria.
• Advanced CT techniques, including thin-slice and multiplanar reconstructions, improve bladder cancer staging and metastasis evaluation.
• MRI remains valuable for assessing tumor invasion depth but is challenging post-transurethral resection.

Conclusions:

• Multislice spiral CT with multiphase CTU, alongside cystoscopy, is the current imaging standard for patients with hematuria.
• CT and MRI can visualize bladder cancer and perivesical infiltration.
• MRI offers superior assessment of tumor invasion depth into the bladder wall compared to CT.