Accuracy of contrast-enhanced ultrasound in the detection of bladder cancer.
OBJECTIVE
To assess the accuracy contrast-enhanced ultrasound (CEUS) in bladder cancer detection using transurethral biopsy in conventional cystoscopy as the reference standard and to determine whether CEUS improves the bladder cancer detection rate of baseline ultrasound.


METHODS
43 patients with suspected bladder cancer underwent conventional cystoscopy with transurethral biopsy of the suspicious lesions. 64 bladder cancers were confirmed in 33 out of 43 patients. Baseline ultrasound and CEUS were performed the day before surgery and the accuracy of both techniques for bladder cancer detection and number of detected tumours were analysed and compared with the final diagnosis.


RESULTS
CEUS was significantly more accurate than ultrasound in determining presence or absence of bladder cancer: 88.37% vs 72.09%. Seven of eight uncertain baseline ultrasound results were correctly diagnosed using CEUS. CEUS sensitivity was also better than that of baseline ultrasound per number of tumours: 65.62% vs 60.93%. CEUS sensitivity for bladder cancer detection was very high for tumours larger than 5 mm (94.7%) but very low for tumours <5 mm (20%) and also had a very low negative predictive value (28.57%) in tumours <5 mm.


CONCLUSIONS
CEUS provided higher accuracy than baseline ultrasound for bladder cancer detection, being especially useful in non-conclusive baseline ultrasound studies.
Diagnostic Imaging Center, Hospital Clinic, University of Barcelona, Barcelona, Spain. cnicolau@clinic.ub.es
C
C
Nicolau
L
L
Bunesch
L
L
Peri
R
R
Salvador
J M
JM
Corral
C
C
Mallofre
C
C
Sebastia
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003558:Cystoscopy; D005260:Female; D006417:Hematuria / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012015:Reference Standards; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods; D001749:Urinary Bladder Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology
D003287:Contrast Media