To assess the accuracycontrast-enhancedultrasound (CEUS) in bladder cancerdetection using transurethral biopsy in conventional cystoscopy as the reference standard and to determine whether CEUS improves the bladder cancerdetection rate of baseline ultrasound.
43 patients with suspected bladder cancer underwent conventional cystoscopy with transurethral biopsy of the suspicious lesions. 64bladder cancers were confirmed in 33 out of 43 patients. Baseline ultrasound and CEUS were performed the day before surgery and the accuracy of both techniques for bladder cancerdetection and number of detected tumours were analysed and compared with the final diagnosis.
CEUS was significantly more accurate than ultrasound in determining presence or absence of bladder cancer: 88.37% vs 72.09%. Seven of eight uncertain baseline ultrasound results were correctly diagnosed using CEUS. CEUS sensitivity was also better than that of baseline ultrasoundper number of tumours: 65.62% vs 60.93%. CEUS sensitivity for bladder cancerdetection was very high for tumours larger than 5 mm (94.7%) but very low for tumours <5 mm (20%) and also had a very low negative predictive value (28.57%) in tumours <5 mm.
CEUS provided higher accuracy than baseline ultrasound for bladder cancerdetection, being especially useful in non-conclusive baseline ultrasound studies.