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Magnetic Resonance Imaging Assessment of Carcinogen-induced Murine Bladder Tumors

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Is cystoscopy indicated for incidentally identified bladder wall thickening?

Daniel S McPartlin¹, Adam P Klausner, Charles U Nottingham

¹Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298-0118, USA.

The Canadian Journal of Urology

|February 26, 2013

Summary

Incidental bladder wall thickening on CT scans rarely indicates cancer. Cystoscopy for focal bladder mass lesions has a higher chance of detecting malignancy, while diffuse or focal thickening does not yield cancer diagnoses.

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Area of Science:

Urology
Oncology
Radiology

Background:

Computed tomography (CT) scans can incidentally reveal bladder wall thickening.
The clinical significance of these incidental findings requires further investigation.

Purpose of the Study:

To assess the diagnostic yield of cystoscopy for detecting bladder cancer when the indication is incidentally found bladder wall thickening on CT scans.

Main Methods:

Retrospective review of 3000 cystoscopies (2006-2009).
Identification of patients with incidental bladder wall thickening on prior CT scans.
Categorization of thickening as diffuse, focal, or focal mass; data collection on patient demographics, risk factors, and outcomes.

Main Results:

22 patients (0.7%) had incidental bladder wall thickening; 3 had focal mass lesions.
5 patients (22.7%) required biopsy; 2 (9.1%) were diagnosed with low-grade, superficial bladder cancer.
No malignancies were found in patients with diffuse or focal bladder wall thickening.

Conclusions:

Incidental diffuse or focal bladder wall thickening on CT has a low yield for detecting malignancy.
Focal bladder mass lesions identified incidentally warrant further investigation due to a higher likelihood of malignancy.