Abstract
Bladder cancer (BC) is the most common cancer of the urinary tract in the United States. Imaging plays a significant role in the management of patients with BC, including the locoregional staging and evaluation for distant metastatic disease, which cannot be assessed at the time of cystoscopy and biopsy/resection. We aim to review the current role of cross-sectional and molecular imaging modalities for the staging and restaging of BC and the potential advantages and limitations of each imaging modality. CT is the most widely available and frequently utilized imaging modality for BC and demonstrates good performance for the detection of nodal and visceral metastatic disease. MRI offers potential value for the locoregional staging and evaluation of muscular invasion of BC, which is critically important for prognostication and treatment decision-making. FDG-PET/MRI is a novel hybrid imaging modality combining the advantages of both MRI and FDG-PET/CT in a single-setting comprehensive staging examination and may represent the future of BC imaging evaluation.
Highlights
Bladder cancer (BC) is the most common cancer of the urinary tract in the United States, accounting for 80,470 new cases and 17,670 deaths in 2019 [1]
Localized BC is subdivided into two distinct clinical entities based on staging differentiated by the presence or absence of invasion of the muscularis propria layer
This distinction is important in the risk-stratification and treatment algorithm of patients with localized BC
Summary
Bladder cancer (BC) is the most common cancer of the urinary tract in the United States, accounting for 80,470 new cases and 17,670 deaths in 2019 [1]. Localized BC is subdivided into two distinct clinical entities based on staging differentiated by the presence or absence of invasion of the muscularis propria layer. This distinction is important in the risk-stratification and treatment algorithm of patients with localized BC. Magnetic resonance imaging (MRI) has been evaluated for locoregional staging, including the evaluation of muscularis propria invasion. Positron emission tomography (PET) with [18 F]fluorodeoxyglucose (FDG) is valuable in the whole-body staging and restaging of many cancers, and its use in cases of suspected metastatic BC or follow-up staging in cases undergoing treatment for metastatic BC is common.
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