To assess the accuracy of contrast-enhanced ultrasound (CEUS) in bladder cancer detection using transurethral biopsy in conventional cystoscopy as the reference standard and to determine whether CEUS improves the bladder cancer detection rate of baseline US.

43 patients with suspicion of bladder cancer underwent conventional cystoscopy with transurethral biopsy of the suspicious lesions. 64 bladder cancers were confirmed in 33 out of 43 patients. Baseline US and CEUS were performed the day before surgery and the accuracy of both techniques for bladder cancer detection and for number of detected tumours were analysed and compared with the final diagnosis.

CEUS accuracy was significantly better than US accuracy in terms of presence or absence of bladder cancer: 88.37% vs 72.09%. Seven of eight uncertain baseline US results were correctly diagnosed using CEUS. CEUS sensitivity was also better than that of baseline US per number of tumours: 65.62% vs 60.93%. CEUS sensitivity for bladder cancer detection 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 US for bladder cancer detection, being especially useful in non-conclusive baseline US studies.

PMID: 21123306 [PubMed - as supplied by publisher] Source: National Library of Medicine.