Diagnostic Efficiency of Multidetector Computed Tomography With Multiplanar Reformatted Imaging and Virtual Cystoscopy in the Assessment of Bladder Tumors After Transurethral Resection

Abstract

In the assessment of recurrent bladder tumors, diagnostic efficiency of virtual cystoscopy carried out by multidetector computed tomography (MDCT) was investigated and compared with the criterion standard of conventional cystoscopy. Twenty-seven patients between 39 and 83 years who had undergone transurethral resection because of bladder tumors were assessed using virtual and conventional cystoscopy. Virtual cystoscopy was performed using a 16-MDCT (Aquilion, Toshiba Medical Systems, Tokyo, Japan) in the supine and prone positions. After axial scanning, the 2-dimensional axial images were assessed, followed by coronal and sagittal multiplanar reconstruction of the images. In addition, virtual cystoscopy and cystographic investigations were performed using software in which volume-rendering technical algorithms shaded the surface display. In the images obtained, the existence and localization of lesions, morphological features, environment invasions, involvement of lymph nodes, and, if any, metastases of abdomen were assessed. For bladder pathologies, the sensitivity and specificity of CT cystography coupled with virtual cystoscopy were 91% and 92%, respectively. The percentage of correct diagnoses using CT cystography was 92%. In addition to bladder pathologies, we investigated liver metastases, kidney cysts, fluid in abdomen, and lymphadenopathies. Using MDCT with virtual cystoscopy to assess primary bladder tumors and, in particular, to determine tumor recurrence after transurethral resection is a minimally invasive method that can be used in the long-term follow-up care of patients.