For the purposes of this document, we make a distinction between CTU and CT abdomen and pelvis without and with IV contrast. CT abdomen and pelvis without and with IV contrast is defined as any protocol not specifically tailored for evaluation of the upper and lower urinary tracts and without both the precontrast and excretory phases. MRU MR urography (MRU) is also tailored to improve imaging of the urinary system. Unenhanced MRU relies upon heavily T2-weighted imaging of the intrinsic high signal intensity from urine for evaluation of the urinary tract. IV contrast is administered to provide additional information regarding obstruction, urothelial thickening, focal lesions, and stones. A contrast-enhanced T1-weighted series should include corticomedullary, nephrographic, and excretory phase. Thin-slice acquisition and multiplanar imaging should be obtained. For the purposes of this document, we make a distinction between MRU and MRI abdomen and pelvis without and with IV contrast. MRI abdomen and pelvis without and with IV contrast is defined as any protocol not specifically tailored for evaluation of the upper and lower urinary tracts, without both the precontrast and excretory phases, and without heavily T2-weighted images of the urinary tract. Discussion of Procedures by Variant Variant 1: Nonmuscle invasive bladder cancer with no symptoms or risk factors. Post-treatment surveillance. In patients with NMIBC without symptoms or risk factors, metastatic disease is uncommon, thus screening for distant metastatic disease is not recommended. Bladder recurrence is common following treatment for NMIBC. In a study of 190 patients with low-grade Ta disease, bladder cancer recurrence was identified in 43.2% (82 of 190) Post-Treatment Surveillance of Bladder Cancer of patients; however, progression to MIBC was seen in only 2 patients [18]. The incidence of upper-tract UC (UTUC) in this patient population is 0.6% to 0.9% [19,20].
Post Treatment Surveillance of Bladder Cancer. For the purposes of this document, we make a distinction between CTU and CT abdomen and pelvis without and with IV contrast. CT abdomen and pelvis without and with IV contrast is defined as any protocol not specifically tailored for evaluation of the upper and lower urinary tracts and without both the precontrast and excretory phases. MRU MR urography (MRU) is also tailored to improve imaging of the urinary system. Unenhanced MRU relies upon heavily T2-weighted imaging of the intrinsic high signal intensity from urine for evaluation of the urinary tract. IV contrast is administered to provide additional information regarding obstruction, urothelial thickening, focal lesions, and stones. A contrast-enhanced T1-weighted series should include corticomedullary, nephrographic, and excretory phase. Thin-slice acquisition and multiplanar imaging should be obtained. For the purposes of this document, we make a distinction between MRU and MRI abdomen and pelvis without and with IV contrast. MRI abdomen and pelvis without and with IV contrast is defined as any protocol not specifically tailored for evaluation of the upper and lower urinary tracts, without both the precontrast and excretory phases, and without heavily T2-weighted images of the urinary tract. Discussion of Procedures by Variant Variant 1: Nonmuscle invasive bladder cancer with no symptoms or risk factors. Post-treatment surveillance. In patients with NMIBC without symptoms or risk factors, metastatic disease is uncommon, thus screening for distant metastatic disease is not recommended. Bladder recurrence is common following treatment for NMIBC. In a study of 190 patients with low-grade Ta disease, bladder cancer recurrence was identified in 43.2% (82 of 190) Post-Treatment Surveillance of Bladder Cancer of patients; however, progression to MIBC was seen in only 2 patients [18]. The incidence of upper-tract UC (UTUC) in this patient population is 0.6% to 0.9% [19,20].