COMPUTED TOMOGRAPHY OR MAGNETIC RESONANCE IMAGING − OUR EXPERIENCES IN DETERMINING PREOPERATIVE TNM STAGING OF BLADDER CANCER

Bladder cancer is the ninth most common cancer diagnosis worldwide. Early detection of bladder cancer is important, since up to 47% of bladder cancer-related deaths might be avoided. Aim: To show our experience in determining the staging of bladder cancer with multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI), making comparison of stage accuracy with contrast enhanced MDCT, conventional MR imaging and dynamic contrast-enhanced MR imaging on the one hand and pathoistological diagnoses after transurethral resection of the nonmuscle invasive bladder cancers or radical cystectomy for patients with muscle-invasive bladder cancers. Materials and methods: Ninety patients with histologically proved bladder cancer were prospectively examined with MDCT, conventional and dynamic MR imaging before tumour resection. Results: Staging was correct in 55.6% with CT, 56.7% with conventional MRI and in 86.7% with dynamic MRI, which was highly significant compared with CT and conventional MRI. Overestimation for superficial tumors was high with CT (31.25%) and conventional MR imaging (25%), but was significantly reduced with dynamic MR imaging (8.3%). The percentages of underestimation in surgically proved invasive tumours (pT2- pT4) were lowest with dynamic MR imaging. Conclusion: CT and MR imaging are less accurate in the evaluation of the depth of mural invasion and for both techniques overstaging is the most frequent error. Dynamic contrast-enhanced MRI with 87% of accuracy, 8.3% overestimation for superficial tumours and lowest underestimation for invasive tumours, make this imaging considerably more accurate.