Role of multidetector CT virtual cystoscopy compared to conventional cystoscopy in the diagnosis of urinary bladder neoplasms

Background The study was done to assess the utility of multidetector CT virtual cystoscopy versus conventional cystoscopy in the diagnosis of urinary bladder tumors. Thirty patients were included, 23 patients with recently diagnosed bladder masses, 7 patients with history of previously resected bladder masses. Conventional cystoscopy was done to all patients with biopsy of suspicious lesions. CT examinations were performed with a 16 and a 320-MDCT scanners. Multiplanar reconstructed (MPR) images were obtained. Also virtual cystoscopic images were obtained with the volume rendering technique and the same software used for MPR images. Results CTVC detected 9 out of 10 polypoid masses detected by conventional cystoscopy (90% sensitivity), 23 out of 23 sessile masses (100% sensitivity), 4 out of 4 areas of wall thickening (100% sensitivity), and 0 out of 1 case mucosal color change (0% sensitivity). Conclusion CTVC is a minimally invasive technique that can be of value for primary diagnosis, surveillance and screening of urinary bladder neoplasms.

Virtual cystoscopy and colonoscopy to assess deep infiltrating endometriosis

Introduction: Faced with a suspicion of endometriosis, transvaginal sonography is the first-line procedure to diagnose deep infiltrating endometriosis. Methods: We recently introduced the FlyThru® mode from TOSHIBA aplio 500. With the 3D acquisition (Multiplanar Reconstruction), we can assess the deep invasion of the endometriosis nodule into the digestive and bladder wall and provide a virtual colonoscopy or cystoscopy. The entire wall of the organ can be explored either by starting the animation or by rotating the arrow. The detection threshold can be adjusted manually from 45 to 100 in order to remove any artifacts. Results: We reported two deep infiltrating endometriosis nodules explored with FlyThru mode: the first one in the rectum and the second in the bladder. Similar to a colonoscopy, the virtual animation of the FlyThru mode showed the progression into the intestine lumen until the visualization of the bulge of the nodule. Operators can appreciate precisely the location, the degree of stenosis, and the circumferential involvement of the bowel wall. The bulges of the two nodules were also visible into the bladder. The size of the lesions was assessed and related to bladder volume, which represents important preoperative data. Conclusion: Three dimensional-transvaginal sonography combined with the FlyThru mode allows the enhanced practitioner to diagnose and assess the invasion of an endometriosis nodule in a single procedure.

Can CT Virtual Cystoscopy Replace Conventional Cystoscopy in Early Detection of Bladder Cancer?

Aim. To correlate findings of conventional cystoscopy with CT virtual cystoscopy (CTVC) in detecting bladder tumors and to evaluate accuracy of virtual cystoscopy in early detection of bladder cancer.Material and Method. From June 2013 to June 2014, 50 patients (46 males, four females) with history and investigations suggestive of urothelial cancer, with mean age 62.76 ± 10.45 years, underwent CTVC by a radiologist as per protocol and subsequently underwent conventional cystoscopy (CPE) the same day or the next day. One urologist and one radiologist, blinded to the findings of conventional cystoscopy, independently interpreted the images, and any discrepant readings were resolved with consensus.Result. CTVC detected 23 out of 25 patients with bladder tumor(s) correctly. Two patients were falsely detected as negative while two were falsely labeled as positive in CTVC. Virtual and conventional cystoscopy were comparable in detection of tumor growth in urinary bladder. The sensitivity, specificity, positive predictive value, and negative predictive value of virtual cystoscopy were 92% each.Conclusion. CTVC correlates closely with the findings of conventional cystoscopy. Bladder should be adequately distended and devoid of urine at the time of procedure. However, more studies are required to define the role of virtual cystoscopy in routine clinical practice.