Serial transabdominal sonography of bladder cancer

In 23 patients with known transitional cell carcinoma of the bladder, 58 serial transabdominal sonograms were obtained, providing 35 cases in which interval change could be evaluated by sonography. Results were correlated with cystoscopy or surgery. Sonography accurately gauged change in 29 instances (83%), of which 13 showed increase, four decrease, and 12 stability of tumor. Errors in assessing interval change occurred when surgery between sonograms caused secondary bladder deformity or patchy edema of the bladder wall; these were misinterpreted as tumor growth. When smooth bladder thickening was present, sonography could not differentiate flat tumor from edema. In no case in which the bladder wall was normal on sonography was tumor found. In four cases sonography was a more accurate indicator of depth of tumor than cystoscopy was. These results suggest that sonography is a useful adjunct to cystoscopy and may be a dependable means of decreasing the frequency of invasive procedures to evaluate the extent of bladder disease. The use of these two techniques together may improve the accuracy achieved by using cystoscopy alone.