The roentgenographic assessment of bladder tumors:A comparison of the diagnostic a ccuracy of roentgenographic techniques

Abstract

Various roentgenographic and clinical methods, used for the staging of bladder lesions, are compared to establish their relative accuracy. Cystoscopy appears to be particularly reliable in Stages O to B1, the group most refractory to staging by arteriography. Conversely, arteriography in conjunction with endovesical and perivesical gas studies appears to be extremely reliable in Stages B2 to D. A retrospective assessment of our group of 32 patients, assinging the diagnosis on basis of cystoscopy in Stages O to B1 and on basis of arteriography in conjunction with endovesical and perivesical gas studies in Stages B2 to D, resulted in a diagnostic accuracy of 94%. This degree of accuracy in preoperative evaluation of bladder tumors probably represents optimal diagnostic accuracy in biologic sciences. Double contrast air-barium cystography is the preferred technique for demonstration of tumors in diverticula of the bladder. Other roentgenographic techniques, such as superimposition cystography and plain cystography, appear to add little to the already established data. Intravenous urography may be used for assessment of the functional status of the kidney and ascertainment of an obstruction of the ureter.