Comparison of Accuracy Between CT Versus MRI  in Staging of Muscle Invasive Bladder Carcinoma

BACKGROUND:
Transitional cell carcinoma of the bladder is one of the most widely recognized cancers affecting the genitourinary tract and it is the second most common cancer in Iraqi male population .Cross sectional imaging studies assume a significant role in the staging of this cancer , also the prognosis of the patients with bladder carcinoma worsens with higher stage and accurate preoperative radiological staging is required to increase cancer free survival for patients submitted for radical cystectomy.
OBJECTIVE:
To compare the accuracy of computed tomography and magnetic resonance imaging for staging of muscle-invasive bladder cancer.
PATIENTS AND METHODS:
Twenty patients were included in the study hnd undergone staging for their muscle invasive bladder cancer by the use of computed tomography scan and magnetic resonance imaging at least two weeks of their last trans-urethral resection of tumour, the radiological staging was compared to the staging of the histopathological reports of the radical cystectomy of the included patients.
RESULTS:
The staging accuracy of the computed tomography was 93.8%, sensitivity 88.8%, specificity 90.2%, while magnetic resonance imaging accuracy of staging was 71.30%, sensitivity 45.8%, specificity 81.70%. Accuracy increased with advancing stage.
CONCLUSION:
It is concluded that computed tomography staging is more accurate than magnetic resonance imaging tumor staging in patients with muscle invasive bladder cancer, with comparable results in lymph node staging.

Keywords

References

1. Husband JES, Reznek RH. Imaging in oncology, 2nd ed. London, UK: Taylor & Francis, 2004:343–74.

2. Ng CS. Radiologic diagnosis and staging of renal and bladder cancer. InSeminars in roentgenology 2006 ; 41: 121-38). WB Saunders Ltd.

3. Knox MK, Cowan NC, Rivers-Bowerman MD, Turney BW. Evaluation of multidetector computed tomography urography and ultrasonography for diagnosing bladder cancer. Clinical radiology. 2008;63:1317-25.

4. Sadow CA, Silverman SG, O'Leary MP, Signorovitch JE. Bladder cancer detection with CT urography in an Academic Medical Center. Radiology. 2008;249:195-202.

5. Husband JE. Staging bladder cancer. Clinical radiology. 1992;46:153-59.

6. MacVicar AD. Bladder cancer staging. BJU international. 2000;86:111-22.

7. Jager GJ, Barentsz JO, Oosterhof GO, Witjes JA, Ruijs SJ. Pelvic adenopathy in prostatic and urinary bladder carcinoma: MR imaging with a three-dimensional TI-weighted magnetization-prepared-rapid gradient-echo sequence. AJR. American journal of roentgenology.1996; 167:1503-7.

8. Husband JE. Computer tomography and magnetic resonance imaging in the evaluation of bladder cancer. J Belge Radiol 1995;78:350–55.

9. Knap MM, Lundbeck F, Overgaard J. Prognostic factors, pattern of recurrence and survival in a Danish bladder cancer cohort treated with radical cystectomy. Acta Oncologica. 2003;42:160-68.

10.McHugh ML. Interrater reliability: the kappa statistic. Biochemia medica: Biochemia medica. 2012;22:276-82.

11.Bostrom PJ, Van Rhijn BW, Fleshner N, Finelli A, Jewett M, Thoms J, Hanna S, Kuk C, Zlotta AR. Staging and staging errors in bladder cancer. European Urology Supplements. 2010;9:2-9.

12.PAIK ML, SCOLIERI MJ, Brown SL, SPIRNAK JP, RESNICK MI. Limitations of computerized tomography in staging invasive bladder cancer before radical cystectomy. The Journal of urology. 2000;163:1693-96.

13.JC Koss JC, Arger PH, Coleman BG, Mulhern Jr C, Pollack HM, Wein AJ. CT staging of bladder carcinoma. American Journal of Roentgenology. 1981;137:359-62.

14. Amendola MA, Glazer GM, Grossman HB, Aisen AM, Francis IR. Staging of bladder carcinoma: MRI-CT-surgical correlation. American Journal of Roentgenology. 1986;146:1179-83.

15.Tritschler S, Mosler C, Straub J, Buchner A, Karl A, Graser A, Stief C, Tilki D. Staging of muscle-invasive bladder cancer: can computerized tomography help us to decide on local treatment?. World journal of urology. 2012;30:827-31.

16.Drieskens O, Oyen R, Van Poppel H, Vankan Y, Flamen P, Mortelmans L. FDG-PET for preoperative staging of bladder cancer. European journal of nuclear medicine and molecular imaging. 2005 ;32:1412-17.

17.Tekes A, Kamel I, Imam K, Szarf G, Schoenberg M, Nasir K, Thompson R, Bluemke D. Dynamic MRI of bladder cancer: evaluation of staging accuracy. American Journal of Roentgenology. 2005 ;184:121-27.

18.Hayashi N, Tochigi H, Shiraishi T, Takeda K, Kawamura J. A new staging criterion for bladder carcinoma using gadolinium‐enhanced magnetic resonance imaging with an endorectal surface coil: a comparison with ultrasonography. BJU international. 2000;85:32-36.