Routine surveillance of the upper urinary tract in asymptomatic, low-risk patients is not recommended. Urine cytological analysis and cystoscopy are performed routinely in the setting of NMIBC and are felt to be sufficiently accurate for the diagnosis of bladder cancer recurrent in this patient population [4,21,22]. CT Abdomen and Pelvis In patients with NMIBC without risk factors or symptoms, screening for distant metastatic disease with cross- sectional imaging (CT abdomen and pelvis without or with IV contrast) is not supported. CT Chest Chest CT is generally not appropriate for patients with NMIBC without symptoms or risk factors. CTU CTU CTU is a primary imaging test for comprehensive evaluation of the genitourinary tract that can be used to identify metastatic disease and metachronous UC. In the setting of NMIBC without symptoms or risk factors, metastatic disease is uncommon; thus, screening for distant metastatic disease is not supported. Although bladder recurrence is common, CT is not supported to screen for bladder recurrence, and it is generally felt that urine cytological evaluation and cystoscopy are sufficiently accurate for the diagnosis of bladder recurrence in this patient population. The incidence of UTUC in this patient population is 0.6% to 0.9% [19,20]. In addition, in a study of 935 patients with history of NMIBC, only 29% (15 of 51) of UTUCs were diagnosed on routine imaging while the remaining UTUCs were diagnosed once patients became symptomatic, for an overall imaging efficacy of 0.49% (15 UTUC out of 3,074 CT examinations) [23]. Routine surveillance of the upper urinary tract in asymptomatic, low-risk patients is not supported. FDG-PET/CT Skull Base to Mid-Thigh Imaging with PET using the tracer fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)/CT is generally not appropriate for patients with NMIBC without symptoms or risk factors. The risk of metastatic disease is extremely low.
Post Treatment Surveillance of Bladder Cancer. Routine surveillance of the upper urinary tract in asymptomatic, low-risk patients is not recommended. Urine cytological analysis and cystoscopy are performed routinely in the setting of NMIBC and are felt to be sufficiently accurate for the diagnosis of bladder cancer recurrent in this patient population [4,21,22]. CT Abdomen and Pelvis In patients with NMIBC without risk factors or symptoms, screening for distant metastatic disease with cross- sectional imaging (CT abdomen and pelvis without or with IV contrast) is not supported. CT Chest Chest CT is generally not appropriate for patients with NMIBC without symptoms or risk factors. CTU CTU CTU is a primary imaging test for comprehensive evaluation of the genitourinary tract that can be used to identify metastatic disease and metachronous UC. In the setting of NMIBC without symptoms or risk factors, metastatic disease is uncommon; thus, screening for distant metastatic disease is not supported. Although bladder recurrence is common, CT is not supported to screen for bladder recurrence, and it is generally felt that urine cytological evaluation and cystoscopy are sufficiently accurate for the diagnosis of bladder recurrence in this patient population. The incidence of UTUC in this patient population is 0.6% to 0.9% [19,20]. In addition, in a study of 935 patients with history of NMIBC, only 29% (15 of 51) of UTUCs were diagnosed on routine imaging while the remaining UTUCs were diagnosed once patients became symptomatic, for an overall imaging efficacy of 0.49% (15 UTUC out of 3,074 CT examinations) [23]. Routine surveillance of the upper urinary tract in asymptomatic, low-risk patients is not supported. FDG-PET/CT Skull Base to Mid-Thigh Imaging with PET using the tracer fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)/CT is generally not appropriate for patients with NMIBC without symptoms or risk factors. The risk of metastatic disease is extremely low.