Bladder cancer diagnosis: the role of CT urography

To evaluate the diagnostic performance of computed tomography urography (CTU), we first compared it with cystoscopy and subsequently analyzed which CTU phase of acquisition has the highest diagnostic accuracy in identifying bladder cancer.

In 2013, 177 patients underwent both cystoscopy and CTU. For all acquisition phases, we calculated sensitivity, specificity, diagnostic accuracy, and positive and negative predictive value (PPV and NPV, respectively). We also evaluated the Cohen κ coefficient.

Computed tomography urography sensitivity, specificity, diagnostic accuracy, PPV, and NPV were as follows: 96.3%, 86.4%, 92.8%, 92.9%, and 92.7%; concordance calculated with Cohen κ was good: 0.8413. The arterial acquisition phase showed the highest diagnostic accuracy, identifying 93.4% of all lesions.

Computed tomography urography is an accurate examination for the diagnosis of bladder cancer, and the arterial acquisition phase provides the best diagnostic information.