A Review On The Accuracy Of Bladder Cancer Detection Methods
Chao-Zhe Zhu1, Hua-Nong Ting1
1. Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia2. Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia3. Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Corresponding author: Assoc. Prof. Dr. Hua-Nong TING, Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia. Tel: +603-7967 6882 Fax: +603-79561378 Email: tinghnedu.my.
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Cancers A Ct Scan Can Easily Detect
Screening mammograms have the power to detect breast cancer. Colonoscopies can detect and prevent colon cancer. But not every cancer has a regular screening testespecially if you have a cancer thats harder to detect. Thats where a CT scan for cancer comes in.
At American Health Imaging , we offer diagnostic CT scans that can easily detect bladder cancer, kidney cancer, ovarian cancer, stomach cancer and even colon cancer.
Read Also: How To Fix Bladder Issues
Why Get A Ct Scan To Detect Cancer
Despite decades of research, there are still many types of cancer that arent easily found with a simple blood test or X-ray. For example, kidney cancer is the sixth most common new cancer found in men and the eighth most common in women, but it often has no symptoms until it has progressed to a higher stage or metastasized.
How Bladder Cancer Is Diagnosed
If you or a loved one is being evaluated for bladder cancer, it can be a stressful and overwhelming time. But by learning as much as you can about the condition, including the tests performed to diagnose it, you are already taking an active role in your care.
Also, try to stay as organized as possible, be inquisitive about selecting your bladder cancer team, and attend appointments and tests with a partner or trusted loved one.
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Flexible Cystoscopy And Biopsy
During a flexible cystoscopy, the doctor applies a local anesthetic and then inserts a cystoscope, a small flexible tube containing a tiny, lighted video camera on the end, into the urethra. He or she guides the cystoscope into the bladder to view the organs inner lining.
If the doctor sees unusual tissue or growths, a biopsy may be performed. During a biopsy, tissue is removed for examination under a microscope, so that the doctor can determine whether cancer is present. Cystoscopy can cause minor irritation of the bladder, which may result in some bleeding shortly afterward.
NYU Langone is a leader in using blue light cystoscopy, an advanced imaging procedure that helps to better detect and treat noninvasive bladder cancer tumors. Our surgeons perform this procedure using a light-sensitive contrast solution that is injected into the bladder through a catheter, or hollow tube, placed in the urethra.
After this solution accumulates in bladder cancer cells, our doctors place a cystoscope with a special blue light on the end into the bladder. The contrast solution makes the cancer cells glow brightly under the blue lightenabled cystoscope. This allows surgeons to ensure more complete tumor removal, reducing the chances of a recurrence or the need for repeat surgeries.
Radiological Test: Ct Urogram
The CT urogram is a radiological test to explore possible reasons for blood in the urine or other symptoms. This specialized scan uses intravenous contrast . A CT urogram examines the upper urinary tract in detail.
This test is good at finding tumors of the kidney, renal pelvis, and ureter, as well as other urologic abnormalities. It may identify kidney stones and hydronephrosis . In addition, the entire abdomen and pelvis is also imaged. This allows a radiologist to identify other abnormalities in these parts of the body. In patients with cancer, it will help identify signs of spread to lymph nodes or other organs like the liver.
Your healthcare provider will request blood work to see if you have normal kidney function before you can receive the contrast required for a CT urogram. If the contrast cannot be given, your healthcare provider may decide to perform a CT scan without contrast or other imaging study. A procedure called cystoscopy with retrograde pyelograms may be suggested. The urologist performs x-rays while injecting dye into the ureters. Like a CT urogram, it can help to identify abnormalities of the ureter and renal pelvis.
While some bladder tumors may be found on a CT urogram or other imaging test, others will not. A urologist will often recommend a cystoscopy to evaluate the lower urinary tract for a source of blood in the urine or to workup other urologic symptoms.
Read Also: My Bladder Always Feels Full
Which Treatment Is Best
To know which procedure is best for you, youll need personalised guidance from your urologist. The decision of which procedure is best for you is taken based on the size of your stone, its position and the structure of your kidney.
Mr Haider Syed has spent many years providing patients with solutions to their kidney stones visit his profileto get in touch and learn how he can help you.
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Role Of Fdg Pet/ct Imaging For Lymph Nodes In Mibc
A 1030% risk of pelvic LN metastasis are known in patients with MIBC. With extending into the peri-vesical fatty tissue, the risk increases up to 50% . Assessment of LN metastases is limited on the basis of solely LN size as both CT and MRI could not identify metastases in normal-sized or minimally enlarged nodes. The sensitivity for detecting LN metastases is low, as is the specificity since the nodal enlargement may be due to benign disease. Overall, CT and MR are not sufficiently accurate in the evaluation of preoperative LN involvement in bladder cancer .
Currently, no evidence is supporting that PET can be routinely used in the nodal staging of bladder cancer. Diverse small-scale trials have been widely undertaken using various imaging protocols. Delayed pelvic images after profuse oral hydration and/or diuretics administration are most commonly used among the various techniques that have been studied to improve the diagnostic performances of FDG PET . There have been several small prospective and retrospective trials for performance staging LNs, the results of which varied widely. The reported sensitivity, specificity, positive predictive value , negative predictive value , and accuracy was 15100%, 80100%, 13100%, 33100%, and 6597%, respectively .
Table 1Table 2
What Treatment Is Offered For Small Stones
If the stone is 4mm or less and your urine and blood results are normal, the stone is likely able to flow out the body naturally with urine. In these cases, treatment is mainly conservative and for relief. You might be sent home with oral pain relief medication and have a follow-up scheduled in a clinic to review if your condition has been resolved.
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When A Ct Scan Misses Cancer
A female patient came to see me with some difficulty swallowing, a very routine issue for a gastroenterologist. I performed an scope examination of her esophagus and confronted a huge cancer occupying the lower portion of her esophagus.
I expected a benign explanation for her swallowing issue. She was relatively young and not particularly ill. She had seen my partner years in the past for a similar complaint, which he effectively treated by stretching her esophagus. I expected that I my procedure would be a re-run. I was wrong.
Prior to the procedure, we chatted, and I learned that she had recently undergone a CT scan of the chest ordered in response to some respiratory symptoms, which were not severe. After I had completed my scope examination of her, I was amazed that no mention of this tumor was related to the patient, who had told me that only a hiatal hernia was seen.
I requested a fax of the report which confirmed that the radiologist made no mention of an esophageal abnormality. I assumed that this scan was not interpreted properly by the radiologist who somehow missed this large, consequential mass in the esophagus. Fortunately, this error caused no harm as I found the cancer just two weeks later.
If Im worried about a patient, but the data all scream that he is healthy, should I relax? If a patient feels superb, but the scan shows something found by accident, do I sharpen up the scalpel?
I am gastroenterologist. I prefer to go with my gut.
Information Gained From Imaging
The emergency department is a common setting for the initial presentation of patients with obstructing stones. Such a diagnosis might be suspected without imaging however practitioners must entertain a wide differential diagnosis for patients with severe abdominal and/or flank pain. Imaging modalities with high sensitivity provide the clinician with confidence that symptoms are caused by an alternative pathology when no stones are visualized. Alternatively, imaging modalities with high specificity demonstrate that a patientâs symptoms are related to stones when they are visualized. Measurements of sensitivity and specificity can vary widely throughout the literature based on several factors, including the method used as the reference standard to determine true-positive and true-negative values, and the population of patients being examined.
Broadly, the available imaging modalities include CT, ultrasonography, KUB radiography, and MRI. The sensitivity, specificity, dose of ionizing radiation, and relative costs vary between modalities . An algorithm is also proposed for imaging patients with suspected stones in the emergency department setting .
A proposed algorithm for imaging patients with acute stone disease in the emergency department
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Urine Tumor Marker Tests
Different urine tests look for specific substances made by bladder cancer cells. One or more of these tests may be used along with urine cytology to help see if you have bladder cancer. These include the tests called NMP22® , BTA Stat®, Immunocyt® , and UroVysion®, which are discussed in Can Bladder Cancer Be Found Early?
Some doctors find these urine tests useful in looking for bladder cancers, but they may not help in all cases. Most doctors feel that cystoscopy is still the best way to find bladder cancer.
Some of these tests are more helpful for finding bladder cancer that has come back in someone who has already had it, rather than first diagnosing it.
If You Do Have Bladder Cancer
If you are diagnosed with cancer, there is nothing that can prepare you for that news and most people find they experience a whirlwind of emotions. Along with rising panic, you may be feeling overwhelmed, frightened and probably angry.
As a newly diagnosed bladder cancer patient, you are embarking on a journey. Right now, as you begin this journey, the most important thing you should know is: you are not alone.
There are thousands of others living with this disease, and there are people and resources to help you find the information you need to help you make the best choices, and the support you need to get you through.
Whether you have to wait just half an hour or two weeks for results, it will seem like forever. Hang on in there this is all part of you getting the best treatment.
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Why Ct Scans Just Won’t Cut It
On top of that, there are other reasons why cancer diagnoses and treatment plans based on a CT scan are far less accurate and effective than those based on better tests that are available to you now!
So when your cancer diagnosis and treatment plan is based on a CT scan, its appropriate for you to want more information and to wonder if there might be something more you can do to have better confidence and control over what is happening to you.
A cancer diagnosis is overwhelming for the best of us!
It makes perfect sense that if youve gotten a cancer diagnosis, you might feel too overwhelmed with emotion to want to start to tackle the logistics involved in getting the best possible treatment. Where would you even start, right?
But…you probably already know exactly what you DONT WANT! And that is a good start…
- You dont want to constantly be wondering whats happening in your body.
- You dont want to be worrying if your treatment is the right one or if its working.
- You dont want to be anxious all the time, because you don’t know if your cancer is starting to grow elsewhere or if your tumors are shrinking.
- And you sure as heck dont want to be wondering for the rest of your life if you are truly cancer free… …Right?
We understand how you feel, and we are here to help you. You do not need to do this alone.
We believe that knowledge is power.
Nina Ostend, client Marge and Gary Hildebrand, client Damian Latch, client and colon cancer survivor
What Is A Cystoscopy
Its a diagnostic procedure during which a doctor inserts a cystoscope equipped with a lens into the urethra and further into the bladder.
This enables viewing of the urethra and the lining of the bladder.
Symptoms of bladder cancer have varying presentations, says Dr. Rice.
Symptoms of UTI without documented infections should be worked up by a physician to rule out anatomical abnormalities, stones and cancers.
For more information on the UTI Tracker, go to utitracker.com.
Dr. Rice is with Inova Medical Group in Fairfax, VA, and her clinical interests include bladder, kidney and prostate cancer, minimally invasive surgery and robotic surgery.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.
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Medical History And Physical Exam
Your doctor will want to get your medical history to learn more about your symptoms. The doctor might also ask about possible risk factors and your family history.
A physical exam can provide information about possible signs of bladder cancer and other health problems. The doctor might do a digital rectal exam , during which a gloved, lubricated finger is put into your rectum. If you are a woman, the doctor might do a pelvic exam as well. During these exams, the doctor can sometimes feel a bladder tumor, determine its size, and feel if and how far it has spread.
If the doctor finds things that aren’t normal, you may to have lab tests done and you might be referred to a urologist for further tests and treatment.
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Detecting Bladder Cancer With Ct Scans
A CT scan uses x-rays to obtain cross-sectional images of the body. Compared to a general x-ray test, which directs a broad x-ray beam from a single angle, the CT scan uses a number of thin beams to produce a series of images from different angles. These images are then digitally reconstructed to create a single image representing a slice of a particular region in the body.
A CT scan of the kidneys, ureters and bladder is referred to as a CT urogram.
How Is Bladder Cancer Diagnosed
If a patient presents any of the above listed symptoms that indicate bladder cancer, then the doctor may perform some specific tests to confirm the diagnosis. These tests also reveal if the cancer has spread to any other part of the body. If this happens, it is called metastasis.
One of the following methods or tests may be used to confirm the diagnosis:
How to diagnose bladder cancer?
Doctors use many tests such as urinalysis, cystoscopy and imaging tests to diagnose and confirm bladder cancer.
For most types of cancer, a biopsy is the only way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a lab. However, if a biopsy is not possible, the doctor may suggest other tests that will help make a confirmed diagnosis. Besides, a doctor may prescribe certain imaging tests that may be used to find out if the bladder cancer has spread and to help with staging.
Can a CT scan detect bladder cancer?
A computed tomography scan of the abdomen and pelvis can show if the urinary system is normal, and if cancer is present and how far it has spread outside the bladder.
Can a MRI scan detect bladder cancer?
Can a PET scan detect bladder cancer?
A PET-CT scan can help to diagnose the following:
- Find out the size of the cancer and if it has spread
- Before surgery to assess the type of surgery
- Post treatment to show how well your treatment is working
Can bladder cancer be detected with a urine test?
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