title: Comparison of virtual cystoscopy and ultrasonography for bladder cancer detection: a meta-analysis.
abstract: OBJECTIVE
  Bladder cancer is the most commonly diagnosed malignancy in patients presenting with haematuria. Early detection is crucial for improving patient prognosis. We therefore performed a meta-analysis to evaluate and compare the detection validity (sensitivity and specificity) of virtual cystoscopy (VC) and ultrasonography (US).
  
  
  METHODS
  We searched MEDLINE, EMBASE, PubMed and the Cochrane Library for studies evaluating diagnosis validity of VC and US between January 1966 and December 2009. Meta-analysis methods were used to pool sensitivity and specificity and to construct a summary receiver-operating characteristic (SROC) curve.
  
  
  RESULTS
  A total of 26 studies that included 3084 patients who fulfilled all of the inclusion criteria were considered for inclusion in the analysis. The pooled sensitivity for bladder cancer detection using CT virtual cystoscopy (CTVC), MR virtual cystoscopy (MRVC) and US was 0.939 (95% CI, 0.919-0.956), 0.908 (95% CI, 0.827-0.959) and 0.779 (95% CI, 0.744-0.812), respectively. The pooled specificity for bladder cancer detection using CTVC, MRVC and US was 0.981 (95% CI, 0.973-0.988), 0.948 (95% CI, 0.884-0.983) and 0.962 (95% CI, 0.953-0.969), respectively. The pooled diagnostic odd ratio (DOR) estimate for CTVC (604.22) were significantly higher than for MRVC (144.35, P<0.001) and US (72.472, P<0.001).
  
  
  CONCLUSIONS
  Our results showed that both CTVC and MRVC are better imaging methods for diagnosing bladder cancer than US. CTVC has higher diagnostic value (sensitivity, specificity and DOR) for the detection of bladder cancer than either MRCT or US.
authors.affiliation: Department of Nuclear Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China.
authors.forename: Xinhua
authors.initials: X
authors.lastname: Qu
authors.forename: Xiaolu
authors.initials: X
authors.lastname: Huang
authors.forename: Lianming
authors.initials: L
authors.lastname: Wu
authors.forename: Gang
authors.initials: G
authors.lastname: Huang
authors.forename: Xiong
authors.initials: X
authors.lastname: Ping
authors.forename: Weili
authors.initials: W
authors.lastname: Yan
mesh_terms: D003558:Cystoscopy / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology