Primary cancer of the urinary bladder: CT evaluation of the T parameter with different techniques

The evaluation of mural invasion (T) in primary urinary bladder carcinoma i s important in the planning of an appropriate surgical or radiochemotherape utic strategy. Previous investigators using computed tomography (CT) have e valuated the bladder filled with urine, urine opacified with iodinated cons trast material, or air insufflation. The purpose of this trial was to estab lish which of these three techniques was the most accurate by comparing dat a obtained in postoperative staging (pT). Sixty-five patients with primary bladder cancer were enrolled, all of whom were studied by spiral CT with th ese three techniques. Patients were assigned to four stage groups:Ta-T1, T2 -T3a, T3b, and T4. The results demonstrated total accuracies of 95% for the air-insufflated bladder, 90.5% for opacified urine, and 87% for noncontras t studies. In conclusion, the air-insufflated bladder is the more accurate technique in the evaluation of the T parameter in primary bladder cancer, e specially in the first and third stage groups.