Diagnostic Strategy of CT Urography as a Prior Examination in the Detection of Bladder Cancer

Purpose: To prospectively assess the diagnostic potential of computed tomography urography (CTU) as a prior examination in the detection of bladder cancer. Materials and Methods: A total of 3280 CTU examinations were assessed in 3050 consecutive patients. Patients who were over 35 years of age, w...

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Main Authors: Yeo Kyoung Nam, See Hyung Kim, Mi Jeong Kim, Hee Jung Lee, Seung Hyun Cho
Format: Article
Language:English
Published: The Korean Society of Radiology 2018-07-01
Series:대한영상의학회지
Subjects:
Online Access:https://doi.org/10.3348/jksr.2018.79.1.33
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author Yeo Kyoung Nam
See Hyung Kim
Mi Jeong Kim
Hee Jung Lee
Seung Hyun Cho
author_facet Yeo Kyoung Nam
See Hyung Kim
Mi Jeong Kim
Hee Jung Lee
Seung Hyun Cho
author_sort Yeo Kyoung Nam
collection DOAJ
description Purpose: To prospectively assess the diagnostic potential of computed tomography urography (CTU) as a prior examination in the detection of bladder cancer. Materials and Methods: A total of 3280 CTU examinations were assessed in 3050 consecutive patients. Patients who were over 35 years of age, with gross hematuria, persistent microhematuria, or a history of urothelial tumor, were included in our study. Our study investigated the diagnostic capability of CTU over the course of two prior examinations. After the first examination, patients with a definite lesion observed by CTU were referred directly for rigid cystoscopy (RC) and patients with negative or probable lesion were referred for flexible cystoscopy (FC). After the second examination, patients with a definite lesion observed by CTU were referred directly for RC, patients with probable lesion were referred for FC, and patients with negative lesion were referred for clinical follow-up. Performance characteristics for the two prior examinations were determined by using pathologic findings or clinical follow-up as the reference standard. Results: The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for detecting bladder cancer were 95.2%, 95.4%, 95.4%, 69.1%, and 99.2%, respectively, for the first prior examination, and 93.4%, 93.3%, 93.3%, 61.1%, and 98.4%, respectively, for the second prior examination. Conclusion: CTU as a prior examination is accurate for the early detection of bladder cancer. Notably, when used as a second prior examination, CTU could help to avoid the unnecessary use of FC in patients with negative lesions.
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spelling doaj.art-fdc0b21e18874176beee4ff515cd22192022-12-22T01:43:36ZengThe Korean Society of Radiology대한영상의학회지1738-26372288-29282018-07-017913339https://doi.org/10.3348/jksr.2018.79.1.33Diagnostic Strategy of CT Urography as a Prior Examination in the Detection of Bladder CancerYeo Kyoung Nam0See Hyung Kim1Mi Jeong Kim2Hee Jung Lee3Seung Hyun Cho4Department of Radiology, Keimyung University, Dongsan Hospital, Daegu, KoreaDepartment of Radiology, Keimyung University, Dongsan Hospital, Daegu, KoreaDepartment of Radiology, Keimyung University, Dongsan Hospital, Daegu, KoreaDepartment of Radiology, Keimyung University, Dongsan Hospital, Daegu, KoreaDepartment of Radiology, Kyungbook National University, Kyungbook National University Chilgok Hospital, Daegu, KoreaPurpose: To prospectively assess the diagnostic potential of computed tomography urography (CTU) as a prior examination in the detection of bladder cancer. Materials and Methods: A total of 3280 CTU examinations were assessed in 3050 consecutive patients. Patients who were over 35 years of age, with gross hematuria, persistent microhematuria, or a history of urothelial tumor, were included in our study. Our study investigated the diagnostic capability of CTU over the course of two prior examinations. After the first examination, patients with a definite lesion observed by CTU were referred directly for rigid cystoscopy (RC) and patients with negative or probable lesion were referred for flexible cystoscopy (FC). After the second examination, patients with a definite lesion observed by CTU were referred directly for RC, patients with probable lesion were referred for FC, and patients with negative lesion were referred for clinical follow-up. Performance characteristics for the two prior examinations were determined by using pathologic findings or clinical follow-up as the reference standard. Results: The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for detecting bladder cancer were 95.2%, 95.4%, 95.4%, 69.1%, and 99.2%, respectively, for the first prior examination, and 93.4%, 93.3%, 93.3%, 61.1%, and 98.4%, respectively, for the second prior examination. Conclusion: CTU as a prior examination is accurate for the early detection of bladder cancer. Notably, when used as a second prior examination, CTU could help to avoid the unnecessary use of FC in patients with negative lesions.https://doi.org/10.3348/jksr.2018.79.1.33computed tomographyx-rayurographybladder cancercystoscopy
spellingShingle Yeo Kyoung Nam
See Hyung Kim
Mi Jeong Kim
Hee Jung Lee
Seung Hyun Cho
Diagnostic Strategy of CT Urography as a Prior Examination in the Detection of Bladder Cancer
대한영상의학회지
computed tomography
x-ray
urography
bladder cancer
cystoscopy
title Diagnostic Strategy of CT Urography as a Prior Examination in the Detection of Bladder Cancer
title_full Diagnostic Strategy of CT Urography as a Prior Examination in the Detection of Bladder Cancer
title_fullStr Diagnostic Strategy of CT Urography as a Prior Examination in the Detection of Bladder Cancer
title_full_unstemmed Diagnostic Strategy of CT Urography as a Prior Examination in the Detection of Bladder Cancer
title_short Diagnostic Strategy of CT Urography as a Prior Examination in the Detection of Bladder Cancer
title_sort diagnostic strategy of ct urography as a prior examination in the detection of bladder cancer
topic computed tomography
x-ray
urography
bladder cancer
cystoscopy
url https://doi.org/10.3348/jksr.2018.79.1.33
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