Journal Club

CT cystography and virtual cystoscopy in the assessment of new and recurrent bladder neoplasms.
Browne RF, Murphy SM, Grainger R, Hamilton S.
Departments of Radiology and Urology, The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.

Objective: To determine if CT cystography and virtual cystoscopy have a role in the assessment of neoplasms of the urinary bladder.
Material and Methods: Twenty five adults suspected of having bladder tumours underwent CT cystography. Twenty three had subsequent virtual cystoscopic reconstructions from the axial data. The examinations were reviewed by two radiologists and the findings were correlated with those at conventional cystoscopy.
Results: Seventeen masses larger than 0.5cm were identified by CT cystography in 16 patients. Two patients had normal CT cystography, but one had small recurrent neoplasms on conventional examination. Seven patients had nodular mucosal irregularities which were subsequently shown to be neoplastic in three. Accuracy for diagnosis of neoplasm in all patients was 88%.
Conclusion: CT cystography is very accurate at identifying masses larger than 0.5cm and can show mucosal abnormalities as small as 2mm. It is minimally invasive and can be diagnostic when conventional cystoscopy is inconclusive. It can indicate appropriate areas for assessment and biopsy at conventional examination. Virtual cystoscopy gave comparable views to conventional cystoscopy, but did not add diagnostic information. It is not likely to replace conventional cystoscopy, but may be helpful in occasional circumstances where the latter is inconclusive, or can not be performed.

Eur J Radiol. 2005 Jan;53(1):147-53