Bladder Cancer Detected with 3-D Sonography
Data published in the Journal of Ultrasound Medicine indicates that a new diagnostic approach for bladder cancer may include three-dimensional sonography.
A Turkish research group evaluated this approach in a series of 31 patients who had either confirmed or suspected bladder cancer. Patients underwent both standard cystoscopy as well as 3-D ultrasound; the imaging studies were completed within 15 days of each other. Findings with the two different approaches were compared.
Data from the 3-D sonography provided a study akin to virtual cystoscopy. Exams included 3-D planar, multiplanar reconstruction, and gray scale images. This allowed extensive assessment of bladder lesions, including morphologic characteristics, size, location, and number.
Over ninety percent of the images obtained provided excellent image quality. Conventional cystoscopy did, however, detect more of the lesions. The sensitivity and specificity of 3-D sonography were 96.2 and 70.6 percent for tumor detection alone. The positive predictive value and the negative predictive value were 93.9 and 80 percent, respectively. These diagnostic characteristics of 3-D sonography were all improved by combining multiplanar reconstruction, 3-D virtual sonography, and gray- scale sonography.
Data analysis indicates that findings obtained with 3-D sonography are comparable to those obtained with cystoscopy. Importantly, this approach defines the bladder cancer size, location, and perivesical spreading of the tumor. Advantages of this approach include the fact that it is less invasive than other approaches, such as cytoscopy. If further data validates these findings, cystoscopy may be reserved for patients with equivocal findings on 3-D sonography.
Bladder cancer is the fourth most common cancer diagnosed in American men and the tenth most commonly diagnosed in women living in the United States. It is most commonly diagnosed in patients nearing 70 years, which makes noninvasive approaches even more appealing because of a reduced risk of potential complications.
January 11, 2008 Related topics: Diagnostic, Renal & Urology, Radiology