title: The diagnostic accuracy of multidetector computed tomography with multiplanar reformatted imaging and virtual cystoscopy in the early detection and evaluation of bladder carcinoma: comparison with conventional cystoscopy.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of multidetector computed tomography (MDCT) with multiplanar reformatted imaging and virtual cystoscopy (VC) in early detection and evaluation of bladder masses with comparison with conventional cystoscopic findings.
  
  
  METHODS
  This prospective study included 35 patients with suspected bladder cancer were studied by computed tomographic cystography (CTC) and virtual cystography (VC) in both the supine and prone positions after distending the bladder with air. The patient population was divided into three groups based on lesion size at conventional cystoscopy (CC). Results of the CT study were compared with those of CC.
  
  
  METHODS
  Sensitivity, specificity, positive, and negative predictive value was used to study the association between VC and CC as regarding lesion detection.
  
  
  RESULTS
  The size of the tumors varied from 2 mm to occupying more than three quarters of the bladder. Of the 71 lesions detected on CC, 47 lesions were positive in histopathology, 28 were <4 mm (19 were positive and 9 were negative for neoplasia), and four of these were missed on VC, with one of 3 mm missed on CC and correctly located by VC. Thus, all lesions of >4 mm were detected by VC and 24 of 28 <4 mm. The locations of all were correctly described at VC when compared with CC. The overall sensitivity of VC vs. CC was 94.36%, specificity 71.42%, PPV was 97.1%, and NPV was 55.55%.
  
  
  CONCLUSIONS
  Cystoscopy remains the standard of reference for the evaluation of the urinary bladder, but MDCT is indicated for examination of patients on whom CC is contraindicated, difficult to perform, unsatisfactory in interpretation, and as an adjuvant tool in the evaluation of areas difficult to assess with CC.
authors.affiliation: Department of Radiology, El Minya University, El Minya High Road, El Minya, Egypt. Mohammed_amin37@yahoo.com
authors.forename: Mohammed Farghally
authors.initials: MF
authors.lastname: Amin
authors.forename: Amr Mohamed
authors.initials: AM
authors.lastname: Abd El Hamid
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D003558:Cystoscopy / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D003287:Contrast Media