The role of 3-dimensional sonography and virtual sonographic cystscopy in detection of bladder tumors

Introduction: Bladder cancer is the second most common genitourinary malignancy. Recent technological advances have led to the development of virtual endoluminal internal views similar to those obtained with conventional endoscopy (virtual cystoscopy). Objectives: To evaluate the potential value of virtual cystoscopy in the detection and follow up of bladder tumors. Patients and methods: A total of 50 patients from Ain Shams University Hospital were studied between August 2012 and April 2014 at Ain Shams’ Radiology Department and Sonoscan Radiology Center. All patients underwent 2D-US, 3D virtual sonographic cystoscopy and conventional cystoscopy, with results compared for sensitivity and specificity in correlation with the site, size and shape of the tumor. Results: 3D virtual cystoscopy showed a sensitivity of 96.5%; while its specificity in identifying lesions was 85.7%; positive predictive values were 96.5%; negative predictive value were 85.7%. The sensitivity of the 2D ultrasound was 77.2%; while its specificity in identifying lesions was 57.1%; positive predictive values came at 88%; negative predictive value were 38.1%. Calculations were made taking into consideration the conventional cystoscopy “gold standard”. Conclusion: Additional to lower costs and no radiation exposure, 3D sonography appears comparable to the use of CT scans and MRI in providing virtual cystoscopy in investigating bladder cancer. Virtual sonographic cystoscopy may therefore be a useful alternative for screening and follow up of tumors, particularly if conventional cystoscopy cannot be performed. However, 3D sonography cannot replace pathological staging, and there is still a need to further improve this technology for enhanced assessment of mucosal abnormalities. Keywords: Virtual cystoscopy, 3D ultrasonography, Bladder tumors, TCC, Haematuri