[Ultrasonographic assessment of bladder tumors: clinical staging]

Staging of urinary bladder cancer is quite important since it is closely related to the prognosis of patients and also determines the mode of treatment. In the past, several techniques have been developedd for this purpose. Cystoscopy, bimanual examination, cystography and biopsy are useful for determines T categories of TNM classification and pelvic angiography also is utilizing, but these methods only provide indirect information on cancer infiltration and some of the methods require skill, especially pelvic angiography is rather complicated and accurate evaluation is difficult to obtain. We develope a new technique by transurethral intravesical ultrasonic scanning for preoperative staging of bladder cancer. The device uses a transurethrally intubated probe with a head that can be angled 90 degree against its long axis. Results of staging by this technique on 83 cases of bladder cancer were reported. Comparison of ultrasonic and pathological stages showed concordance in 59 of 61 removed by total or partial cystectomy (17 cases, with 30 tumors) and TUR (44 cases). At present time, this scanner was developed to obtain a real-time image. Diameter of probe sheath was reduced to 24 F. The resolution of the tomogram was improved by 7 MHz. ultrasound, which clearly displayed the ureteral penetration of the bladder wall. Outline of diagnostic criteria are as follows Ta, T 1: The normal thickness of the wall beneath the tumor T 2: The bladder wall is indented slightly at the tumor base T 3: marked thickening of the bladder wall and sonolucent mass occupies the whole thickness of the wall The pretreatment classification by the TNM system is commonly utilized throughout the world. Out ultrasonic technique will be one of the essential examination for clinical cancer staging of the bladder in years to come.