title: The role of transcavitary ultrasonography in diagnosis and staging of nonmuscle-ınvasive bladder cancer: a prospective non-randomized clinical study.
abstract: To evaluate the efficacy of cystoscopy, computed tomography (CT), transcavitary ultrasound (TCUS) and cytology, separately and in combination, for the diagnosis and evaluation of superficial bladder cancer. Initial cystoscopy and wash-out cytology were performed for 1548 patients. Of these, 206 with proven bladder tumors were included in this prospective study. CT and TCUS were performed for patients with bladder tumors without knowledge of their cystoscopy results. The lesions were classified as low- (pTa) and high- (pT1) risk superficial tumors according to multiplicity and size. Patients were divided into three categories according to their cystoscopically evaluated tumor size: ≤1 cm (88 patients, 42.7%), 1-3 cm (51 patients, 24.8%) and ≥3 cm (67 patients, 32.5%). TCUS identified 46 (22.3%) high-risk patients with/without invasion and 160 (77.7%) low-risk patients with no invasion. Overall, the sensitivity, specificity, positive predictive value and negative predictive value of TCUS for tumor detection were 77.4%, 60%, 94.7% and 22.2%, respectively. Cystoscopy remains the most widely used technique for the diagnosis of bladder cancer. The combined use of CT, TCUS and cytology detected 72% of cystoscopically proven tumors. Among the three, TCUS findings exhibited the strongest correlation with cystoscopy findings.
authors.affiliation: Department of Urology, Samatya Training and Research Hospital, Istanbul, Turkey.
authors.forename: Gultekin Cagri
authors.initials: GC
authors.lastname: Oktem
authors.affiliation: Kafkas Department of Urology, University Faculty of Medicine, Kars, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Kocaaslan
authors.affiliation: Kafkas Department of Urology, University Faculty of Medicine, Kars, Turkey ; Kafkas Üniversitesi Tıp Fakültesi Hastanesi, Üroloji A.B.D, Kars, Türkiye.
authors.forename: Mert Ali
authors.initials: MA
authors.lastname: Karadag
authors.affiliation: Kafkas Department of Urology, University Faculty of Medicine, Kars, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Bagcioglu
authors.affiliation: Kafkas Department of Urology, University Faculty of Medicine, Kars, Turkey.
authors.forename: Aslan
authors.initials: A
authors.lastname: Demir
authors.affiliation: Kafkas Department of Urology, University Faculty of Medicine, Kars, Turkey.
authors.forename: Kursat
authors.initials: K
authors.lastname: Cecen
authors.affiliation: Kafkas Department of Urology, University Faculty of Medicine, Kars, Turkey.
authors.forename: Erdinc
authors.initials: E
authors.lastname: Unluer
keywords: Computed tomography; Cystoscopy; Nonmuscle-invasive bladder cancer; Transrectal ultrasound