Virtual cystoscopy: the evaluation of bladder lesions with computed tomographic virtual cystoscopy

PURPOSE: Our objective was to assess the accuracy of computed tomographic virtual cystoscopy (CTVC) in the detection of urinary bladder lesions. METHODS: Twenty-five patients were examined using CTVC. Bladder scanned using multislice CT at a slice thickness of 1 mm. The data were transferred to a workstation for interactive navigation using surface rendering. Findings obtained from CTVC were compared with results from conventional cystoscopy and with pathological findings. RESULTS: Thirty-eight lesions were identified. The smallest was 0.2 × 0.3 cm; the largest was 7 × 4.5 cm. Both CTVC and conventional cystoscopy were used. Conventional cystoscopy detected the same number of lesions that were detected by CTVC. On morphological examination, 26 of the lesions were polypoid, 7 were sessile and 5 were bladder wall-thickening. While one of the polypoid lesions was reported as an inverted papilloma, 2 of the 5 lesions that were identified as wall-thickening were malignant and 3 were benign. The sensitivity of using CTVC to identify neoplasias was 100%; the accuracy was 89%. CONCLUSION: Although the definitive diagnosis of some suspected urinary bladder tumours is only possible with conventional cystoscopy and biopsy, CTVC is a minimally invasive technique which provides beneficial information about urinary bladder lesions.