Radiography Intravenous Urography CTU and, to a lesser extent, MRU have replaced IV urography (IVU) for the evaluation of the upper urinary tract. IVU does not have a current role in surveillance of NMIBC. Post-Treatment Surveillance of Bladder Cancer US Pelvis (Bladder) Because cystoscopy is relatively invasive and time consuming, there is interest in noninvasive and effective imaging modalities to identify recurrent bladder cancer. In a small prospective study, transabdominal ultrasound (US) was found to have a sensitivity of 78.5% and specificity of 100% for the diagnosis of recurrent UC of the urinary bladder, with cystoscopy as the reference standard [32]. In this study, US accurately diagnosed bladder cancer in 78.6% (11 of 14) of patients, missing 2 tumors <3 mm and 1 lesion located in a diverticulum. In another study, the combination of grayscale US, multiplanar reconstruction, and 3-D virtual US had a sensitivity of 96.4% and specificity of 88.8% compared with conventional cystoscopy [33]. Despite these results, it is generally understood that US has limited ability to identify MIBC in clinical practice and is sparingly used. As cystoscopy allows identification of recurrent neoplasm, concurrent biopsy, and local staging, US has not replaced the need for conventional cystoscopic surveillance for patients with NMIBC. Variant 2: Nonmuscle invasive bladder cancer with symptoms or risk factors. Post-treatment surveillance. Patients with NMIBC and risk factors require frequent surveillance for recurrent bladder cancer, which is generally done with conventional cystoscopy. In patients at intermediate risk with a history of TURBT and intravesical chemotherapy, recurrent bladder cancer is identified in up to 57% (413 of 724) of patients [8]. In patients at high risk, 59.6% (2,694 of 4,521) of patients develop multiple recurrences within 2 years of initial treatment [34].
Post Treatment Surveillance of Bladder Cancer. Radiography Intravenous Urography CTU and, to a lesser extent, MRU have replaced IV urography (IVU) for the evaluation of the upper urinary tract. IVU does not have a current role in surveillance of NMIBC. Post-Treatment Surveillance of Bladder Cancer US Pelvis (Bladder) Because cystoscopy is relatively invasive and time consuming, there is interest in noninvasive and effective imaging modalities to identify recurrent bladder cancer. In a small prospective study, transabdominal ultrasound (US) was found to have a sensitivity of 78.5% and specificity of 100% for the diagnosis of recurrent UC of the urinary bladder, with cystoscopy as the reference standard [32]. In this study, US accurately diagnosed bladder cancer in 78.6% (11 of 14) of patients, missing 2 tumors <3 mm and 1 lesion located in a diverticulum. In another study, the combination of grayscale US, multiplanar reconstruction, and 3-D virtual US had a sensitivity of 96.4% and specificity of 88.8% compared with conventional cystoscopy [33]. Despite these results, it is generally understood that US has limited ability to identify MIBC in clinical practice and is sparingly used. As cystoscopy allows identification of recurrent neoplasm, concurrent biopsy, and local staging, US has not replaced the need for conventional cystoscopic surveillance for patients with NMIBC. Variant 2: Nonmuscle invasive bladder cancer with symptoms or risk factors. Post-treatment surveillance. Patients with NMIBC and risk factors require frequent surveillance for recurrent bladder cancer, which is generally done with conventional cystoscopy. In patients at intermediate risk with a history of TURBT and intravesical chemotherapy, recurrent bladder cancer is identified in up to 57% (413 of 724) of patients [8]. In patients at high risk, 59.6% (2,694 of 4,521) of patients develop multiple recurrences within 2 years of initial treatment [34].