In addition, progression to MIBC is seen in 8.6% to 15% of patients with high-risk disease [35-37]. CT Abdomen and Pelvis NMIBC is a heterogeneous group of tumors, and although distant metastatic disease is uncommon in this patient population, cross-sectional imaging may be used to assess for metastatic disease in patients with symptoms or risk factors. There is no relevant literature regarding the use of CT abdomen and pelvis without or with IV contrast for the evaluation of metastatic bladder cancer; however, in the absence of contraindications, IV contrast is generally indicated to improve sensitivity for the identification of metastatic disease. CT abdomen and pelvis without and with IV contrast (excluding CTU) adds little information over CT abdomen and pelvis with IV contrast and does not offer a complete examination of the urinary tract. CTU, however, is a comprehensive examination and can be used to assess for metastatic disease and metachronous upper-tract UC (see below). CT Chest Chest CT without or with IV contrast is generally not appropriate for patients with NMIBC with symptoms or risk factors, unless an abnormality is identified with chest radiography. 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 patients with NMIBC who have symptoms or risk factors. Although CTU has not replaced cystoscopy, CT performs well in identifying recurrent bladder cancer following TURBT. In a study of CTU in 121 patients at risk for urothelial recurrence after TURBT (with symptoms or positive urine cytology), 59 bladder recurrences were identified in 38 patients. The authors found that overall accuracy was better in the urinary bladder during the nephrographic phase compared with the pyelographic/excretory phase (91.7% [354 of 386] versus 83.2% [321 of 386], P = . 038) [38].
Post Treatment Surveillance of Bladder Cancer. In addition, progression to MIBC is seen in 8.6% to 15% of patients with high-risk disease [35-37]. CT Abdomen and Pelvis NMIBC is a heterogeneous group of tumors, and although distant metastatic disease is uncommon in this patient population, cross-sectional imaging may be used to assess for metastatic disease in patients with symptoms or risk factors. There is no relevant literature regarding the use of CT abdomen and pelvis without or with IV contrast for the evaluation of metastatic bladder cancer; however, in the absence of contraindications, IV contrast is generally indicated to improve sensitivity for the identification of metastatic disease. CT abdomen and pelvis without and with IV contrast (excluding CTU) adds little information over CT abdomen and pelvis with IV contrast and does not offer a complete examination of the urinary tract. CTU, however, is a comprehensive examination and can be used to assess for metastatic disease and metachronous upper-tract UC (see below). CT Chest Chest CT without or with IV contrast is generally not appropriate for patients with NMIBC with symptoms or risk factors, unless an abnormality is identified with chest radiography. 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 patients with NMIBC who have symptoms or risk factors. Although CTU has not replaced cystoscopy, CT performs well in identifying recurrent bladder cancer following TURBT. In a study of CTU in 121 patients at risk for urothelial recurrence after TURBT (with symptoms or positive urine cytology), 59 bladder recurrences were identified in 38 patients. The authors found that overall accuracy was better in the urinary bladder during the nephrographic phase compared with the pyelographic/excretory phase (91.7% [354 of 386] versus 83.2% [321 of 386], P = . 038) [38].