title: Bladder cancer: analysis of multi-detector row helical CT enhancement pattern and accuracy in tumor detection and perivesical staging.
abstract: OBJECTIVE
  To evaluate the enhancement pattern of bladder cancer and the accuracy of multi-detector row helical computed tomography (CT) in the detection and staging of bladder cancer.
  
  
  METHODS
  In 20 patients, the attenuation value of bladder cancer was measured on dynamic contrast material-enhanced multiphasic CT images obtained with scanning delays of 40, 60, 80, and 100 seconds. In 67 patients, CT data were obtained with a 60-second scanning delay that covered the bladder (section thickness, 2.5 mm; beam pitch, 1.5) and a 180-second scanning delay that covered the abdomen (section thickness, 5 mm; beam pitch, 1.5). We prospectively evaluated CT images and compared findings at CT with findings at histologic examination. We evaluated cancer detection rate, positive predictive value of cancer detection, and sensitivity and specificity in the diagnosis of perivesical invasion.
  
  
  RESULTS
  The attenuation value of bladder cancers was significantly higher on 60- (105 HU +/- 16) and 80-second (97 HU +/- 15) delayed CT images than on the other images (P <.05). The cancer detection rate and positive predictive value for cancer detection were 97% and 95%, respectively, in 67 patients and increased to 100% and 100%, respectively, in 44 patients with a time interval of 7 or more days between transurethral resection of the bladder (TURB) and CT examination. Sensitivity and specificity in the diagnosis of perivesical invasion were 89% and 95%, respectively, in 67 patients and increased to 92% and 98%, respectively, in 44 patients with a time interval of 7 or more days between TURB and CT examination.
  
  
  CONCLUSIONS
  Bladder cancer tends to show peak enhancement with the 60-second scanning delay. Multi-detector row helical CT is useful in the detection and staging of bladder cancer.
authors.affiliation: Department of Radiology, Asan Medical Center, University of Ulsan, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Korea.
authors.forename: Jeong Kon
authors.initials: JK
authors.lastname: Kim
authors.forename: Soo-Youn
authors.initials: SY
authors.lastname: Park
authors.forename: Han Jong
authors.initials: HJ
authors.lastname: Ahn
authors.forename: Chung Soo
authors.initials: CS
authors.lastname: Kim
authors.forename: Kyoung-Sik
authors.initials: KS
authors.lastname: Cho
mesh_terms: D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery
chemical_list: D003287:Contrast Media