Abstract
ObjectivesTo validate the flexible ultrasound bronchoscope (FUB) as a tool in distinguishing muscle invasive and non-muscle invasive bladder tumors.Materials and MethodsFrom June 2010 to April 2012, 62 patients (11 female and 51 male) with 92 bladder urothelial carcinoma were treated in our study. The mean (±SD) patient age was 64.0±12.5 years old (ranged from 22 to 87). Clinical T stage was assessed by FUB at first in operating room, then immediately initial diagnostic transurethral resection (TUR) was performed. A second TUR would be done 2–4 weeks after initial TUR when the latter was incomplete (in large and multiple tumours, no muscle in the specimen) or when an exophytic high-grade and/or T1 tumour was detected. And radical cystectomy would be performed for the patients who were diagnosed with muscle-invasive tumors. FUB staging and initial TUR staging, final pathological results were compared.ResultsIn ultrasonic images, the normal muscle layer of bladder wall could be clearly distinguished into three layers, which were hyperechogenic mucosa, hypoechogenic muscle and hyperechogenic serosal. For non-muscle invasive tumors, the muscle layers were continuous. And distorted or discontinuous muscle layers could be seen in muscle-invasive case. The overall accuracy (95.7%) and the specificity of muscle invasion detection of FUB (98.8%) were comparable to TUR (overall accuracy 90.2% and specificity 100%), but sensitivity of muscle invasion detection of FUB was significantly higher than initial TUR (72.7%VS18.2%). Moreover, the tumor's diameter could not affect the FUB's accuracy of muscle invasion detection. For tumors near the bladder neck, FUB also showed the similar validity as those far from bladder neck.ConclusionsTo conclude, the flexible ultrasound bronchoscope is an effective tool for muscle invasion detection of bladder tumor with ideal ultrasonic images. It is an alternative option for bladder tumor staging besides TUR. It might have the potentiality to change the bladder diagnostic strategy.
Highlights
The clinical behavior, management strategy and prognosis for nonmuscle-invasive and muscle-invasive bladder cancer differ starkly, so accurate staging of bladder cancer is of great importance, especially distinguishing a nonmuscle-invasive tumor from a muscle-invasive tumor
The overall accuracy (95.7%) and the specificity of muscle invasion detection of flexible ultrasound bronchoscope (FUB) (98.8%) were comparable to transurethral resection (TUR), but sensitivity of muscle invasion detection of FUB was significantly higher than initial TUR (72.7%VS18.2%)
To conclude, the flexible ultrasound bronchoscope is an effective tool for muscle invasion detection of bladder tumor with ideal ultrasonic images
Summary
The clinical behavior, management strategy and prognosis for nonmuscle-invasive and muscle-invasive bladder cancer differ starkly, so accurate staging of bladder cancer is of great importance, especially distinguishing a nonmuscle-invasive tumor from a muscle-invasive tumor. Computed tomography (CT) and magnetic resonance imaging (MRI) have limitations in distinguishing muscle-invasive and nonmuscle-invasive bladder tumors located in the bladder. They were more inclined to be used as tools to detect extravesical tumor involvement and lymph node metastasis [1,2]. Transurethral ultrasound and endoluminal ultrasound (ELUS) are good tools for the staging of bladder tumors that are confined to the bladder wall [3], they are limited by low resolution. To get better images with higher resolution, Horiuchi K used high-frequency ELUS for the staging of bladder tumors [4]. The urethral ingury caused by ELUS examinations, especially for those old men with BPH, is another disadvantage
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
