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Related Concept Videos

Imaging Studies I: Kidney, Ureter, and Bladder Studies01:28

Imaging Studies I: Kidney, Ureter, and Bladder Studies

Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
Imaging Studies II: Ultrasonography01:24

Imaging Studies II: Ultrasonography

IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

Imaging Studies VI: Voiding Cystourethrography and Cystography

Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...

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Related Experiment Video

Updated: Jun 15, 2026

An Orthotopic Bladder Tumor Model and the Evaluation of Intravesical saRNA Treatment
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Image directed redesign of bladder cancer treatment pathways: the BladderPath RCT.

Nicholas James1, Sarah Pirrie2, Wenyu Liu2

  • 1Institute of Cancer Research, London, UK.

Health Technology Assessment (Winchester, England)
|September 9, 2024
PubMed
Summary

Multiparametric MRI significantly reduces treatment delays for muscle-invasive bladder cancer. This imaging approach offers accurate staging, potentially avoiding unnecessary procedures and improving patient outcomes.

Keywords:
BLADDER CANCERCLINICAL PATHWAYCLINICAL TRIALMAGNETIC RESONANCE IMAGINGMRISTAGINGTRANSURETHRAL RESECTIONTURBT

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Area of Science:

  • Urology
  • Oncology
  • Radiology

Background:

  • Transurethral resection of bladder tumour (TURBT) has historically been standard for bladder cancer staging but often leads to inaccuracies and treatment delays.
  • Muscle-invasive bladder cancer (MIBC) requires timely and accurate staging for effective radical treatment.
  • Multiparametric magnetic resonance imaging (mpMRI) presents a non-invasive alternative for rapid and accurate MIBC staging.

Purpose of the Study:

  • To evaluate the feasibility and efficacy of integrating mpMRI before TURBT for suspected MIBC staging.
  • To assess if mpMRI can improve the accuracy and speed of diagnosis and subsequent treatment initiation.

Main Methods:

  • An open-label, multistage randomized controlled study involving 143 newly diagnosed bladder cancer patients across 15 UK hospitals.
  • Patients were randomized into two pathways: Pathway 1 (standard TURBT) and Pathway 2 (mpMRI for suspected MIBC, followed by TURBT if necessary).
  • Key outcomes included protocol adherence in the feasibility stage and time to correct treatment for MIBC in the intermediate stage.

Main Results:

  • The mpMRI-directed pathway (Pathway 2) demonstrated high protocol adherence (92% for MIBC).
  • Median time to correct treatment for MIBC was significantly reduced in Pathway 2 (53 days) compared to Pathway 1 (98 days), with a hazard ratio of 2.9 (p=0.040).
  • Overall median time to correct treatment was also shorter in Pathway 2 (25 days) versus Pathway 1 (37 days).

Conclusions:

  • The mpMRI-directed pathway substantially reduced time to treatment for MIBC by 45 days without negatively impacting non-MIBC patients.
  • Incorporating mpMRI before TURBT into standard care for suspected MIBC is recommended to improve decision-making and accelerate treatment.
  • This approach may reduce costs and morbidity by enabling some patients to avoid TURBT and by facilitating earlier definitive treatment.