title: Comparison of post contrast CT urography phases in bladder cancer detection.
abstract: OBJECTIVE
  The aim of this study was to investigate which post-contrast phase(s) in a four-phase CT urography protocol is (are) most suitable for bladder cancer detection.
  
  
  METHODS
  The medical records of 106 patients with visible haematuria who underwent a CT urography examination, including unenhanced, enhancement-triggered corticomedullary (CMP), nephrographic (NP) and excretory (EP) phases, were reviewed. The post-contrast phases (n = 318 different phases) were randomized into an evaluation order and blindly reviewed by two uroradiologists.
  
  
  RESULTS
  Twenty-one patients were diagnosed with bladder cancer. Sensitivity for bladder cancer detection was 0.95 in CMP, 0.83 in NP and 0.81 in EP. Negative predictive value (NPV) was 0.99 in CMP, 0.96 in NP and 0.95 in EP. The sensitivity was higher in CMP than in both NP (p-value 0.016) and EP (p-value 0.0003). NPV was higher in CMP than in NP (p-value 0.024) and EP (p-value 0.002).
  
  
  CONCLUSIONS
  In the CT urography protocol with enhancement-triggered scan, sensitivity and NPV were highest in the corticomedullary phase, and this phase should be used for bladder assessment.
  
  
  CONCLUSIONS
  • More bladder tumours are detected during the corticomedullary phase than during other phases. • Sensitivity and NPV for bladder cancer detection were highest in corticomedullary phase. • The corticomedullary phase in CT urography should be used for bladder assessment.
authors.affiliation: Department of Surgical Sciences, Section of Radiology, Uppsala University Hospital, SE-751 85, Uppsala, Sweden. malin.helenius@akademiska.se.
authors.forename: Malin
authors.initials: M
authors.lastname: Helenius
authors.affiliation: Department of Surgical Sciences, Section of Radiology, Uppsala University Hospital, SE-751 85, Uppsala, Sweden.
authors.forename: Par
authors.initials: P
authors.lastname: Dahlman
authors.affiliation: Department of Surgical Sciences, Section of Radiology, Uppsala University Hospital, SE-751 85, Uppsala, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Lonnemark
authors.affiliation: Department of Surgical Sciences, Section of Urology, Uppsala University Hospital, SE-751 85, Uppsala, Sweden.
authors.forename: Einar
authors.initials: E
authors.lastname: Brekkan
authors.affiliation: Uppsala Clinical Research Center, Uppsala University Hospital, SE-751 85, Uppsala, Sweden.
authors.forename: Lisa
authors.initials: L
authors.lastname: Wernroth
authors.affiliation: Department of Surgical Sciences, Section of Radiology, Uppsala University Hospital, SE-751 85, Uppsala, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Magnusson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media
keywords: Early detection of cancer; Haematuria; Multidetector computed tomography; Urinary bladder neoplasms; Urography