Quantitative CT Morphometrics: A Novel Approach for Predicting the Bladder Cancer Grade

Area of Science:

• Uro-oncology
• Radiology
• Medical imaging

Background:

• Bladder cancer (BC) grading and staging are crucial for treatment.
• Non-muscle invasive BC (NMIBC) accounts for 75% of cases.
• Accurate preoperative assessment improves patient outcomes.

Purpose of the Study:

• To evaluate the effectiveness of computerized tomography (CT) in predicting histopathological grades of NMIBC.
• To correlate morphological tumor features on CT with BC grade.
• To assess the diagnostic performance of CT-derived morphometric parameters.

Main Methods:

• Retrospective analysis of 100 NMIBC patients undergoing transurethral resection of bladder tumor (TUR-BT).
• CT imaging (128-slice scanner) used to measure tumor height (H) and contact length (CL) in axial, coronal, and sagittal planes.
• Comparison of radiological measurements with histopathological grading (WHO 2004/2016 classification).

Main Results:

• High-grade tumors showed significantly higher H, CL, and H/CL ratio than low-grade tumors (p<0.05).
• Tumor contact length (CL) demonstrated superior specificity, sensitivity, and diagnostic accuracy compared to H and H/CL ratio.
• A CL > 19.1 mm in the axial plane achieved 83% sensitivity and specificity for high-grade BC.

Conclusions:

• Axial plane tumor contact length (CL) on CT urography is a sensitive and specific indicator for detecting high-grade bladder cancer.
• CT-based morphometric analysis can aid in preoperative risk stratification of NMIBC.
• This imaging technique supports informed treatment decisions for bladder cancer patients.