There is no relevant literature regarding the use of CT chest without or with and without IV contrast in the evaluation of bladder cancer metastases to the thorax; however, CT chest is often performed as a component of the imaging follow-up of patients with MIBC. CTU CTU CTU is a primary imaging test for comprehensive evaluation of the genitourinary tract and can be used to identify distant metastatic disease and metachronous UTUC in this patient population. In one study, accuracy of CTU for UTUC was better in the nephrographic phase compared with the pyelographic phase for upper-tract recurrences (86.7% [260 of 300] versus 80.0% [240 of 300], P = . 028), although the 2 phases are complementary [38]. FDG-PET/CT Skull Base to Mid-Thigh FDG-PET/CT in the setting of MIBC is typically used to resolve equivocal findings identified on other imaging tests, but there is increasing evidence that FDG-PET/CT alters patient management and has prognostic value compared with other staging examinations. Kibel et al [50] evaluated FDG-PET/CT prior to cystectomy for MIBC and found that FDG-PET/CT had a sensitivity of 70% (7 of 10) and specificity of 94% (30 of 32) for metastatic disease. However, occult metastatic disease was found in 7 of 42 patients with FDG-PET/CT compared with CT alone. In another study of 44 patients with MIBC, FDG-PET/CT demonstrated a sensitivity of 57% for pelvic lymph node involvement compared with 33% for CT, and FDG-PET/CT identified all bone lesions that were detected by scintigraphy [51]. A more recent study demonstrated a sensitivity of 62% to 79% for nodal metastases based on standardized uptake values [52]. A meta-analysis for nodal metastatic disease demonstrated a pooled sensitivity of 57% and specificity of 92% [53]. Given FDG activity in excreted urine, pelvic staging may be difficult. One group of authors found that with diuretics and oral hydration there was improved assessment of locally recurrent disease [54].
Post Treatment Surveillance of Bladder Cancer. There is no relevant literature regarding the use of CT chest without or with and without IV contrast in the evaluation of bladder cancer metastases to the thorax; however, CT chest is often performed as a component of the imaging follow-up of patients with MIBC. CTU CTU CTU is a primary imaging test for comprehensive evaluation of the genitourinary tract and can be used to identify distant metastatic disease and metachronous UTUC in this patient population. In one study, accuracy of CTU for UTUC was better in the nephrographic phase compared with the pyelographic phase for upper-tract recurrences (86.7% [260 of 300] versus 80.0% [240 of 300], P = . 028), although the 2 phases are complementary [38]. FDG-PET/CT Skull Base to Mid-Thigh FDG-PET/CT in the setting of MIBC is typically used to resolve equivocal findings identified on other imaging tests, but there is increasing evidence that FDG-PET/CT alters patient management and has prognostic value compared with other staging examinations. Kibel et al [50] evaluated FDG-PET/CT prior to cystectomy for MIBC and found that FDG-PET/CT had a sensitivity of 70% (7 of 10) and specificity of 94% (30 of 32) for metastatic disease. However, occult metastatic disease was found in 7 of 42 patients with FDG-PET/CT compared with CT alone. In another study of 44 patients with MIBC, FDG-PET/CT demonstrated a sensitivity of 57% for pelvic lymph node involvement compared with 33% for CT, and FDG-PET/CT identified all bone lesions that were detected by scintigraphy [51]. A more recent study demonstrated a sensitivity of 62% to 79% for nodal metastases based on standardized uptake values [52]. A meta-analysis for nodal metastatic disease demonstrated a pooled sensitivity of 57% and specificity of 92% [53]. Given FDG activity in excreted urine, pelvic staging may be difficult. One group of authors found that with diuretics and oral hydration there was improved assessment of locally recurrent disease [54].