Preoperative imaging for staging bladder cancer

Accurate preoperative staging of bladder cancer is essential in determining the extent of disease and optimal treatment. The current gold standard of transurethral resection of bladder tumor (TURBT) followed by computed tomography (CT) imaging provides excellent staging specificity, but often understages the disease, leading to pathologic upstaging and adverse outcomes in patients undergoing radical cystectomy. Newer imaging modalities, such as multiparametric magnetic resonance (MR) imaging and positron emission tomography (PET) combined with CT or MR provides promising imaging alternatives which may improve accuracy of staging both local and distant disease.