Recognition of bladder tumors by excretory urography

Bladder tumors initially may be diagnosed by excretory urography in patients undergoing the examination because of specific symptoms or unrelated complaints. Among seven strategies tested by six experienced readers, the combination of early, full-bladder, and postvoiding anteroposterior radiographs was most successful in identifying bladder tumors in a series including 20 cases of biopsy-proved bladder tumor and 19 cases of cystoscopically normal bladders. The postvoiding radiograph, when viewed alone, was the single most valuable projection, and resulted in the correct diagnosis of 14 cancers that were not appreciated on any other single radiograph for a given case. The addition of oblique projections to the other three views did not significantly increase diagnostic sensitivity.