Male ; Humans ; Urinary Bladder/diagnostic imaging* ; Prostate/diagnostic imaging* ; Multiparametric Magnetic Resonance Imaging ; Cystitis/diagnostic imaging* ; Hemorrhage/etiology* ; Urinary Bladder Neoplasms/complications*

PURPOSE: The aim of this study was to evaluate the efficacy and safety of hexaminolevulinate fluorescence cystoscopy in the diagnosis of bladder cancer. MATERIALS AND METHODS: In a prospective design, we included patients who had a bladder lesion suggesting bladder cancer. Patients with massive hematuria, urethral Foley catheter insertion, chronic retention state, or urinary tract infection were excluded. After the bladder was emptied, hexaminolevulinate was gently administered into the bladder. One hour later, cystoscopy under white light and blue light was performed. After marking the lesions confirmed with white light or blue light, transurethral resection of the bladder lesion and pathologic confirmation were done. Transurethral resection of the lesions that were negative in both white and blue light was also performed. RESULTS: From April 2010 to September 2010, 30 patients were enrolled. From the total of 30 patients (25 men and 5 women; mean age, 60.4+/-9.22 years), 134 specimens were extracted. Among these, 101 specimens showed positive results by blue light cystoscopy (BLC). The sensitivity of BLC and white light cystoscopy (WLC) was 92.3% and 80.8%, respectively (p=0.021). The specificity of BLC and WLC was 48% and 49.1%, respectively (p>0.05). The positive and negative predictive values of BLC were 71.2% and 81.8%, respectively, whereas those of WLC were 72.0% and 68.6%, respectively. With WLC, 48 specimens showed negative findings, but of that group, 15 specimens (31.2%) were revealed to be malignant with BLC. There were no significant side effects in the 24 hours after the instillation of hexaminolevulinate. CONCLUSIONS: Photodynamic diagnosis with hexaminolevulinate helps to find tumors that could be missed by use of WLC only. Photodynamic diagnosis might be valuable in complete resection as well as for more accurate diagnosis of bladder tumor.
Aminolevulinic Acid ; Catheters ; Cystoscopy ; Diagnostic Imaging ; Fluorescence ; Hematuria ; Humans ; Light ; Male ; Prospective Studies ; Retention (Psychology) ; Sensitivity and Specificity ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Tract Infections

BACKGROUNDThere have been few studies to evaluate the effects of helical CT on bladder tumor. This study was to evaluate the clinical applications of helical CT dynamic contrast-enhanced axial imaging, multiplanar reformation (MPR), three-dimensional (3D) reconstruction and virtual cystoscopy (CTVC) in bladder tumors.

METHODSThe precontrast and four-phase postcontrast helical CT scans were performed in 42 patients with bladder tumors confirmed by conventional cystoscopy and pathology. MPR, 3D and CTVC images were generated from the volumetric data of the excretory phase. The results were then compared with the findings of conventional cystoscopy and surgery in a double-blinded mode.

RESULTSThe sensitivity of the axial, 3D and CTVC images in detecting the bladder tumors were 90.8%, 76.9% and 95.4% respectively. The dynamic contrast-enhanced axial images could provide excellent intramural and extravesical information, and the accuracy in preoperative tumor staging was 87.7%. MPR could directly demonstrate the origin and extravesical invasions of the tumors and their relation to the ureter. 3D and CTVC images were useful for displaying the surface morphology of the tumor and the relationship between the tumor and the ureteric orifices, whereas CTVC could depict the tumors smaller than 5 mm that were not seen on the axial images.

CONCLUSIONSThe combination of axial, MPR, 3D and CTVC images with helical CT can provide comprehensive information on bladder tumor.

Adult ; Aged ; Cystoscopy ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Tomography, Spiral Computed ; methods ; Urinary Bladder Neoplasms ; diagnostic imaging

Catecholamines ; Cystectomy ; Heart Transplantation ; Humans ; Male ; Middle Aged ; Paraganglioma ; diagnostic imaging ; pathology ; surgery ; Time Factors ; Ultrasonography ; Urinary Bladder ; diagnostic imaging ; pathology ; surgery ; Urinary Bladder Neoplasms ; diagnostic imaging ; pathology ; surgery

Aged, 80 and over ; Carcinoma, Transitional Cell ; diagnostic imaging ; pathology ; Humans ; Male ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms ; diagnostic imaging ; pathology

OBJECTIVETo summarize the imaging features of nonepithelial tumors of the bladder.

METHODSThe Imaging findings in 20 surgically treated patients with pathologically proved nonepithelial tumors of the bladder were retrospectively analyzed. The tumors included leiomyoma (n = 9), pheochromocytoma (n = 6), leiomyosarcoma (n = 2), rhabdomyosarcoma (n = 1), carcinosarcoma (n = 1), inflammatory myofibroblastoma (n = 1).

RESULTSThe leiomyomas were round or ellipse in shape with a sharp border and homogeneous density, and showed a low signal intensity on T1WI and T2WI in 1/1 case; slight enhancement on CT after contrast enhancement in 6/7 cases; and a poor blood supply on color Doppler ultrasonography in 3/4 cases. The pheochromocytoma had a round or oval shape and clear border, and slightly lobulated in 4/6 cases, homogeneous density/echo/signal in 5/6 cases, calcification in 1 case, low signal intensity on T1WI and high signal intensity on T2WI in 1/1 case, moderate or marked enhancement on CT and MRI in 4/5 cases, and strong blood supply on color Doppler ultrasonography in 3/4 cases. The inflammatory myofibroblastoma showed the same imaging features as the pheochromocytomas. Other malignant tumors showed an irregular configuration, with a poorly defined border, heterogeneous density/echo/signal and moderate to strong enhancement on CT.

CONCLUSIONMost leiomyomas and pheochromocytomas of the bladder show some typical imaging features on CT, MRI and ultrasound, which are helpful in making correct diagnosis and treatment plan preoperatively. Other malignant nonepithelial bladder tumors do not show special imaging characteristics and can only be diagnosed qualitatively.

Adult ; Aged ; Carcinosarcoma ; diagnosis ; diagnostic imaging ; Female ; Humans ; Leiomyoma ; diagnosis ; diagnostic imaging ; Leiomyosarcoma ; diagnosis ; diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasms, Muscle Tissue ; diagnosis ; diagnostic imaging ; Pheochromocytoma ; diagnosis ; diagnostic imaging ; Retrospective Studies ; Rhabdomyosarcoma ; diagnosis ; diagnostic imaging ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Bladder Neoplasms ; diagnosis ; diagnostic imaging

Objective To investigate the clinicopathological features and immunohistochemical phenotypes of brain metastatic carcinoma in Tibetan patients. Methods The clinical and pathological data of all patients with brain metastases from 2014 to 2020 in Tibet Autonomous Region People's Hospital were retrospectively analyzed,including 13 cases of brain metastatic carcinoma.All cases were diagnosed and classified by immunohistochemical staining. Results 13 cases(9 males and 4 females)of brain metastatic carcinoma,aged 26-62 years old,present with headache,dizziness,nausea and vomiting clinically.Four patients had a medical history of tumor,and among the 9 patients with no history of tumor,7 present space occupying lesions in both the brain and other organs.Imaging data could be found in 10 cases,including 4 cases of single lesion and 6 cases of multiple lesions.Primary tumors were identified in 11 cases(8 located in the lung,including 4 cases of adenocarcinoma,3 cases of small cell carcinoma,and 1 case of squamous cell carcinoma;1 case of urothelial carcinoma of the renal pelvis;1 case of thyroid papillary carcinoma;1 case of uterine choriocarcinoma),whereas the primary tumor was unknown for the other 2 cases(1 case of small cell carcinoma and 1 case of adenocarcinoma). Conclusions Brain metastatic carcinoma are more common among middle-aged and elderly people in Tibet.Most of the cases have no history of tumor,with the initial site at the brain metastatic lesions.The most common primary site is the lung,and the primary site of some cases is unknown.Multiple lesions are common in brain metastatic carcinoma,especially in the cerebral hemisphere.For older patients with multiple brain space occupying lesions,the possibility of brain metastatic carcinoma increases.
Adult ; Aged ; Brain ; Brain Neoplasms/diagnostic imaging* ; Carcinoma, Transitional Cell ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms ; Tibet ; Urinary Bladder Neoplasms

OBJECTIVETo evaluate the diagnostic effect of helical CT on bladder tumor.

METHODSIn 28 patients with bladder tumors which had been confirmed by conventional fiberoptic cystoscopy (FC) and pathology, precontrast and four-phase postcontrast helical CT scans were performed with multiple plane reconstruction (MPR), three dimensional (3D) reconstruction and CT virtual cystoscopy (CTVC) images constructed from the volumetric data of the excretory phase. The results were then compared with the findings of conventional fiberoptic cystoscopy and surgery through a double-blind manner.

RESULTSThe sensitivity of the helical CT axial, 3D and CTVC images in detecting bladder tumor were 92.3%, 76.9% and 96.2% respectively. The accuracy in preoperative tumor staging of helical CT was 83.0%. The axial images could provide excellent intramural and extravesical information, and MPR could directly show the origin and extravesical invasion of the tumor and its relation to the ureter. 3D and CTVC images were useful in displaying the surface morphology of the tumor and its relation with the ureteric orifices, whereas CTVC images could depict a tumor smaller than 5 mm that could not be visualized on the axial images.

CONCLUSIONCombining interpretation of axial, MPR, 3D and CTVC images, helical CT is able to provide comprehensive information for the diagnosis and treatment of bladder tumor.

Adult ; Aged ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms ; diagnostic imaging

OBJECTIVE: To evaluate the performance of 3.0T magnetic resonance imaging examination (MRI) for the local detecting of muscle invasive bladder cancer following transurethral resection of bladder tumor (TURBT). METHODS: Retrospective study identified 55 patients with pathology-proven bladder cancer who underwent transurethral resection of bladder tumor followed by 3.0T magnetic resonance imaging between September 2012 and April 2019 in our hospital. Two radiologists reviewed pelvic magnetic resonance imaging together and judged muscle invasive bladder cancer. Sensitivity, specificity and accuracy were calculated for the presence of muscle invasion by T2 weighted imaging (T2WI) only, diffusion-weighted imaging (DWI) only and T2WI+DWI compared with the findings at radical cystectomy as the reference standard. RESULTS: Of the 55 patients with pathological results from radical cystectomy, 3.64% (2/55) had no residual disease; 29.09% (16/55) were non-muscle invasive bladder cancer on pathology, including 13 cases in T1 and 3 cases in Ta; 34.55% (19/55) were in stage T2 depending on pathology, 25.45% (14/55) in T3, and 7.27% (4/55) in T4. The average age was 60.76 years, ranging from 42 to 82 years. There were 48 males and 7 females in our study. Before pelvic MRI examination, all the patients received transurethral resection of bladder tumor, including 16 cases taking the operation in our hospital and 39 cases in other hospitals. The interval between the pelvic MRI examination and transurethral resection of bladder tumor was more than 2 weeks in all the patients. They all underwent radical cystectomy within 1 month after the pelvic MRI examination, and no patient underwent radiotherapy or chemotherapy in our study during the interval between the MRI examination and radical cystectomy. T2WI only, DWI only, and T2WI+DWI of 3.0T magnetic resonance imaging for readers were with sensitivity: 94.59%, 83.78%, 91.89%; with specificity: 66.67%, 77.78%, 72.22% and with accuracy: 85.45%, 81.82%, 85.45%, respectively. CONCLUSION 3.0T MRI may have a role in diagnosing muscle invasive bladder cancer following TURBT. T2WI has the advantage of detecting the location of bladder tumor, and DWI has the advantage of differentiating between the benign and malignant lesion. 3.0T MRI T2WI+DWI has a good utility in the detection of muscle invasive bladder cancer following TURBT with satisfied accuracy.
Adult ; Aged ; Aged, 80 and over ; Cystectomy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Urinary Bladder Neoplasms/diagnostic imaging*

OBJECTIVETo evaluate CT virtual endoscopy (CTVE) based on spiral CT in the staging diagnosis of bladder neoplasms and its clinical application.

METHODSForty patients with bladder neoplasms and 10 normal patients underwent volume scanning using spiral CT. All images with thin collimation and overlapping reconstruction were transferred to computer workstation to obtain the images of CTVE. The results of all CTVE findings were compared with those of conventional CT, cystoscopy, operation and pathological data.

RESULTSCTVE showed the normal anatomical structure of bladder as actual cystoscopy. The size, configuration, location and extension of bladder neoplasms was detected by CTVE scans agreed with that of actual cystoscopy. CTVE revealed the structure of trigone of urinary bladder that were not available in actual cystoscopy, and they were confirmed operatively and compared with the pathological results according to the TNM classification of malignant neoplasms. The sensitivity of CTVE for bladder tumors and accuracy in preoperative neoplasms staging was 98% (39/40) and 85% (33/39), respectively. The sensitivity of mass detection of diameter > or = 0.5 cm was 100%. The results were studied in a blind way.

CONCLUSIONSCTVE is a noninvasive, safe and reliable procedure in the staging diagnosis of bladder neoplasms. CTVE can well show bladder neck anatomy and serve as an important complementary method to conventional cystoscopy. The limitation of CTVE is that it can not observe change of mucosal appearances and perform biopsy.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; methods ; Sensitivity and Specificity ; Tomography, Spiral Computed ; methods ; Urinary Bladder Neoplasms ; diagnostic imaging ; pathology