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Vol. 59. Issue 5.
Pages 422-430 (September - October 2017)
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Vol. 59. Issue 5.
Pages 422-430 (September - October 2017)
Original article
DOI: 10.1016/j.rxeng.2017.07.005
Virtual cystoscopy, computed tomography urography and optical cystoscopy for the detection and follow-up for bladder cancer
Cistoscopia virtual, urografía por tomografía computarizada y uretrocistoscopia óptica en el diagnóstico y el seguimiento del cáncer de vejiga
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D. Ibáñez Muñoza,
Corresponding author
david_ibi@hotmail.com

Corresponding author.
, I. Quintana Martínezb, A. Fernández Militinoc, D. Sánchez Zalabardod, L. Sarria Octavio de Toledob, R. Cozcolluela Cabrejasa
a Sección de Radiodiagnóstico, Hospital Reina Sofía, Tudela, Navarra, Spain
b Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, Spain
c Departamento de Estadística, Universidad Pública de Navarra (UPNA), Pamplona, Spain
d Sección de Urología, Hospital Reina Sofía, Tudela, Navarra, Spain
Article information
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Tables (3)
Table 1. Summary of VC–OUC findings in patients with macroscopic hematuria and followed due to history of tumors.
Table 2. Summary of VC-OUC findings in patients with macroscopic hematuria.
Table 3. Summary of VC-OUC findings in patients followed due to history of vesical neoplasms.
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Abstract
Objectives

To evaluate the utility of virtual cystoscopy (VC) performed with CT urography in patients being studied under gross hematuria or patients being followed-up after a previous bladder cancer and compare the results with those obtained with gold standard technique (optical cystoscopy).

Methods

Retrospective study of 117 patients who were referred for VC by the Urology Department between May 2014 and May 2015. Those patients presented with gross hematuria or they were previously treated patients from bladder cancer being followed up. These patients were evaluated with MDCT and virtual cystoscopy after distending the bladder with air. The results were compared with those obtained with optical cystoscopy which was performed no more than a week after.

Results

The global sensitivity and specificity of VC were 81.8 and 92.1 per cent. Additional findings detected in CT urography were an aortic dissection, urinary lithiasis and colonic metastasis.

Conclusion

VC seems an useful technique in the diagnosis and follow-up for bladder cancer with a good correlation with OC. The main limitations are the impossibility of biopsy during the procedure and the detection of erythematous lesions. Collateral findings can be detected performed with CT urography although the high radiation exposure does not recommend their combined use.

Keywords:
Cystoscopy
Urography
Computed tomography
Bladder cancer
Hematuria
Resumen
Objetivos

Evaluar la utilidad de la cistoscopia virtual (CV) realizada junto con la urografía por tomografía computarizada (URO-TC) en pacientes en estudio por hematuria macroscópica o en seguimiento por antecedente de cáncer de vejiga tratado, y comparar los resultados con los obtenidos con la técnica de referencia (uretrocistoscopia óptica [UCO]).

Material y métodos

Estudio retrospectivo de 117 pacientes derivados para realización de CV y URO-TC desde el Departamento de Urología entre mayo de 2014 y mayo de 2015. Dichos pacientes presentaban hematuria macroscópica o habían sido tratados previamente por cáncer de vejiga y estaban bajo seguimiento periódico. Fueron sometidos a CV tras la distensión de la vejiga con aire. Los resultados obtenidos fueron comparados con los de la UCO realizada no más de una semana después.

Resultados

La sensibilidad y la especificidad global de la CV fueron del 81,8% y el 92,1%, respectivamente. La tasa de hallazgos críticos (que comprometían la vida del paciente) detectados en la URO-TC realizada junto a la CV fue del 12%, similar a la de otros estudios.

Conclusión

La CV es una técnica útil en el diagnóstico y el seguimiento del cáncer de vejiga, con buena correlación con la UCO. Sus principales limitaciones son la imposibilidad de toma de biopsia y la capacidad para detectar lesiones eritematosas de mucosa. El empleo concomitante de la URO-TC aporta hallazgos incidentales críticos, pero el incremento en la dosis de radiación no justifica el empleo combinado de ambas.

Palabras clave:
Cistoscopia
Tomografía computarizada
Cáncer de vejiga
Hematuria

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