CT evaluation of invasive lesions of the bladder

The role of computed tomography (CT) in defining the extent of local tumor invasion was reviewed retrospectively in 22 patients with biopsy proven malignant lesions of the bladder. These included 14 cases of primary bladder carcinoma and 8 cases of pelvic malignancies with secondary invasion of the bladder. Computed tomography proved accurate in detecting lymph node enlargement, obvious extravesical masses, and relatively small mural of mucosal lesions of the bladder. However, CT was not able to reliably predict microscopic invasion of either the serosal surface of the bladder by pelvic malignancies or microscopic invasion of the perivesical fat by intrinsic bladder carcinoma. These factors, in addition to the inability of CT to detect metastases in normal sized lymph nodes, appear to limit the overall accuracy of CT in the evaluation of locally invasive pelvic malignancies. Nevertheless, CT appears to be a useful noninvasive screening technique to avoid needless radical surgery in advanced lesions with bladder invasion.