CEUS in the differentiation between low and high-grade bladder carcinoma

Area of Science:

• Urology
• Oncology
• Medical Imaging

Background:

• Bladder cancer is a significant health concern, ranking fourth in new diagnoses and tenth in cancer deaths.
• Transitional cell carcinoma (TCC) accounts for over 90% of bladder cancer cases.
• Accurate grading of bladder tumors is crucial for effective treatment planning.

Purpose of the Study:

• To evaluate the efficacy of low mechanical index contrast-enhanced ultrasonography (CEUS) in distinguishing between high- and low-grade bladder transitional cell carcinomas (TCC).
• To assess the added value of time-intensity curves (TIC) in conjunction with CEUS for bladder cancer grading.

Main Methods:

• 144 patients with suspected bladder cancer were included in the study.
• All patients underwent grayscale ultrasonography (US), color-Doppler ultrasonography (CDUS), and CEUS.
• Subsequent cystoscopy and transurethral resection of bladder tumor (TURB) were performed for histological confirmation.

Main Results:

• Histological analysis revealed 88 high-grade (61.1%) and 56 low-grade (38.9%) carcinomas.
• CEUS demonstrated a sensitivity of 90.9% and specificity of 85.7%.
• Time-intensity curves (TIC) achieved a sensitivity of 91.6% and specificity of 85.7%.

Conclusions:

• CEUS is a reliable, noninvasive method for differentiating low- and high-grade bladder carcinomas.
• Typical enhancement patterns and specific contrast-sonographic perfusion curves observed with CEUS aid in accurate tumor grading.
• CEUS offers a valuable tool for noninvasive bladder cancer assessment, potentially reducing the need for more invasive procedures.