title: CEUS in the differentiation between low and high-grade bladder carcinoma.
abstract: BACKGROUND
  Bladder cancer ranks 4th overall in the number of newly diagnosed cancers and 10th in causes of cancer deaths. More than 90% of all cases of bladder cancer are transitional cell carcinoma (TCC). The goal of this study is to confirm the usefulness of low mechanical index contrast-enhanced ultrasonography (CEUS), also in association with time-intensity curves, in the differentiation between high- and low-grade bladder malignant lesions.
  
  
  METHODS
  From February 2006 to February 2012 we recruited 144 patients. All patients underwent grayscale ultrasonography (US), color-Doppler ultrasonography (CDUS) and contrast-enhanced ultrasonography (CEUS). Subsequently all patients underwent cystoscopy and TURB.
  
  
  RESULTS
  HISTOLOGICAL DIAGNOSES WERE: 88 high-grade carcinomas (61.1%), and 56 low-grade carcinomas (38.9%). Sensitivity and specificity of CDUS were 87.5% (126/144) and 60%, respectively. Sensitivity and specificity of CEUS were 90.9% and 85.7%, respectively. Sensitivity and specificity of TIC were 91.6% (132/144) and 85.7%, respectively.
  
  
  CONCLUSIONS
  CEUS is a reliable noninvasive method for differentiating low- and high-grade bladder carcinomas since it provides typical enhancement patterns as well as specific contrast-sonographic perfusion curves.
authors.affiliation: Department of Radiological Sciences, University "La Sapienza", Rome, Italy.
authors.forename: F M
authors.initials: FM
authors.lastname: Drudi
authors.forename: N
authors.initials: N
authors.lastname: Di Leo
authors.forename: F
authors.initials: F
authors.lastname: Malpassini
authors.forename: F
authors.initials: F
authors.lastname: Antonini
authors.forename: E
authors.initials: E
authors.lastname: Corongiu
authors.forename: F
authors.initials: F
authors.lastname: Iori
keywords: Bladder cancer; Color-Doppler ultrasonography, CDUS; Contrast-enhanced ultrasonography, CEUS; Time-intensity curves