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Hu X, Sun C, Ren X, Ge S, Xie C, Li X, Zhu Y, Ding H. Contrast-enhanced Ultrasound Combined With Elastography for the Evaluation of Muscle-invasive Bladder Cancer in Rats. J Ultrasound Med 2023; 42:1999-2011. [PMID: 36896871 DOI: 10.1002/jum.16216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES By comparing with the control group, we evaluated the usefulness of contrast-enhanced ultrasound (CEUS) combined with elastography for the assessment of muscle invasion by bladder cancer (MIBC) in a Sprague-Dawley (SD) rat model. METHODS In the experimental group, 40 SD rats developed in situ bladder cancer (BLCA) in response to N-methyl-N-nitrosourea treatment, whereas 40 SD rats were included in the control group for comparison. We compared PI, Emean , microvessel density (MVD), and collagen fiber content (CFC) between the two groups. In the experimental group, Bland-Altman test was used to assess the relationships between various parameters. The largest Youden value was used as the cut-off point, and binomial logistic regression analysis was performed to analyze the PI and Emean . Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic power of parameters, individually and in combination. RESULTS The PI, Emean , MVD, and CFC were significantly lower in the control group than in the experimental group (P < .05). The PI, Emean , MVD, and CFC were significantly higher for MIBC than for non-muscle-invasive bladder cancer (P < .05). There were significant correlations between PI and MVD, and between Emean and CFC. The diagnostic efficiency analysis showed PI had the highest sensitivity, CFC had the highest specificity, and PI + Emean had the highest diagnostic efficacy. CONCLUSION CEUS and elastography can distinguish lesions from normal tissue. PI, MVD, Emean , and CFC were useful for the detection of BLCA myometrial invasion. The comprehensive utilization of PI and Emean improved diagnostic accuracy and have clinical application.
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Affiliation(s)
- Xing Hu
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Chuanyu Sun
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinping Ren
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Shengyang Ge
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chunmei Xie
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiangyu Li
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yingfeng Zhu
- Department of Pathology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hong Ding
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
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Li Q, Tang J, He E, Li Y, Zhou Y, Wang B. Differentiation between high- and low-grade urothelial carcinomas using contrast enhanced ultrasound. Oncotarget 2017; 8:70883-9. [PMID: 29050329 DOI: 10.18632/oncotarget.20151] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 05/22/2017] [Indexed: 12/12/2022] Open
Abstract
Purpose To evaluate the value of contrast-enhanced ultrasonography (CEUS) in the differentiation of high and low grade urothelial carcinoma. Materials and Methods 192 with 192 bladder lesions, including 110 high grade urothelial carcinoma and 82 low grade urothelial carcinoma were examined by CEUS. Among 192 tumors, enhancement patterns of 96 tumors between August 2010 and December 2012 were analyzed retrospectively. Then from January 2013 to April 2015, compared with CEUS was performed on 96 tumors for prospective differential diagnosis. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value were assessed. Results With the CEUS view, dominant enhancement patterns were revealed as fast wash-in and slow wash-out for high grade urothelial carcinoma, fast wash-in and fast wash-out for low grade urothelial carcinoma, respectively. At CEUS, the prospective differentiation of bladder tumors showed sensitivity 86% , specificity 90%, accuracy 88%, positive predictive value 92%, and negative predictive value 82% for high grade tumors, while sensitivity 85% , specificity 89%, accuracy 88%, positive predictive value 85% and negative predictive value 89% for low grade tumors, respectively. Conclusions Our study demonstrates the great potential of CEUS in the differentiation of high and low grade urothelial carcinoma. Since CEUS is an effective, inexpensive, and non-invasive method. It could be a reliable tool in the evaluation of patients with bladder tumors.
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Truta A, Popon TAH, Saraci G, Ghervan L, Pop IV. Novel non invasive diagnostic strategies in bladder cancer. ACTA ACUST UNITED AC 2016; 89:187-92. [PMID: 27152066 PMCID: PMC4849373 DOI: 10.15386/cjmed-534] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 09/11/2015] [Indexed: 12/13/2022]
Abstract
Bladder cancer is one of the most commonly diagnosed malignancies worldwide, derived from the urothelium of the urinary bladder and defined by long asymptomatic and atypical clinical picture. Its complex etiopathogenesis is dependent on numerous risk factors that can be divided into three distinct categories: genetic and molecular abnormalities, chemical or environmental exposure and previous genitourinary disorders and family history of different malignancies. Various genetic polymorphisms and microRNA might represent useful diagnostic or prognostic biomarkers. Genetic and molecular abnormalities - risk factors are represented by miRNA or genetic polymorphisms proved to be part of bladder carcinogenesis such as: genetic mutations of oncogenes TP53, Ras, Rb1 or p21 oncoproteins, cyclin D or genetic polymorhisms of XPD,ERCC1, CYP1B1, NQO1C609T, MDM2SNP309, CHEK2, ERCC6, NRF2, NQO1Pro187Ser polymorphism and microRNA (miR-143, −145, −222, −210, −10b, 576-3p). The aim of our article is to highlight the most recent acquisitions via molecular biomarkers (miRNAs and genetic polymorphisms) involved in bladder cancer in order to provide early diagnosis, precise therapy according to the molecular profile of bladder tumors, as well as to improve clinical outcome, survival rates and life quality of oncological patients. These molecular biomarkers play a key role in bladder carcinogenesis, clinical evolution, prognosis and therapeutic response and explain the molecular mechanisms involved in bladder carcinogenesis; they can also be selected as therapeutic targets in developing novel therapeutic strategies in bladder malignancies. Moreover, the purpose in defining these molecular non invasive biomarkers is also to develop non invasive screening programs in bladder malignancies with the result of decreasing bladder cancer incidence in risk population.
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Affiliation(s)
- Anamaria Truta
- Medical Genetics Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Research Center of Functional Genomics Biomedicine &Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; I. Chiricuta Oncology Institute, Cluj-Napoca, Romania
| | | | - George Saraci
- Internal Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Liviu Ghervan
- Urology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania, Clinical Institute of Urology and Kidney Transplant Cluj-Napoca, Romania
| | - Ioan Victor Pop
- Medical Genetics Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Byler TK, Reeder JE, Nsouli I. Incidental computed tomographic bladder wall abnormalities: harbinger or herring? Urology 2015; 85:288-91. [PMID: 25623666 DOI: 10.1016/j.urology.2014.09.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 09/22/2014] [Accepted: 09/25/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the outcomes of incidental radiographically identified bladder wall abnormalities in the absence of other urologic indications for evaluation. METHODS All screening cystoscopy evaluations performed at our center over 4 years were identified using surgical logs. We identified patients for whom cystoscopy was performed for a radiographic bladder wall abnormality, defined as diffuse bladder wall thickening, focal bladder wall thickening, or intraluminal bladder mass. Patients with other indications for cystoscopy such as previous bladder cancer, pelvic radiation, or hematuria were excluded. The outcomes including any relevant biopsy or malignant diagnosis were recorded. RESULTS A total of 2483 cystoscopies were performed in 1418 unique patients, with 34 (2%) performed for radiographic bladder wall abnormalities in the absence of other indications for cystoscopy. Eleven of 34 patients (32.4%) were evaluated for diffuse bladder wall thickening, of which 2 had high-grade carcinoma. Fifteen patients (44.1%) had focal bladder wall thickening, all negative at cystoscopy. Four of the 8 patients (23.5%) evaluated for bladder mass had disease (1 high grade, 3 low grade). CONCLUSION Although generally nonspecific for malignancy, incidental radiographic finding of bladder wall abnormality led to diagnosis of urothelial carcinoma in >15% of our patients including 3 worrisome tumors. This finding argues for routine cystoscopy in patients with radiographic bladder wall abnormality even in the absence of hematuria.
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Affiliation(s)
- Timothy K Byler
- Department of Urology, Upstate Medical University, Syracuse, NY.
| | - Jay E Reeder
- Department of Urology, Upstate Medical University, Syracuse, NY
| | - Imad Nsouli
- Department of Urology, Upstate Medical University, Syracuse, NY
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Ahmed FO, Hamdan HZ, Abdelgalil HB, Sharfi AA. A comparison between transabdominal ultrasonographic and cystourethroscopy findings in adult Sudanese patients presenting with haematuria. Int Urol Nephrol 2015; 47:223-8. [DOI: 10.1007/s11255-014-0869-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/24/2014] [Indexed: 10/24/2022]
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Mady HEH, Omar AAM, Elgammal MAA, Ibrahim GHM. Utility of urine cytology in evaluating hematuria with sonographically suspected bladder lesion in patients older than 50 years. Urol Ann 2014; 6:212-7. [PMID: 25125893 PMCID: PMC4127857 DOI: 10.4103/0974-7796.134264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 05/29/2013] [Indexed: 11/20/2022] Open
Abstract
Purpose: Investigate the utility of urine cytology (UC) in patients older than 50 years with hematuria and sonographically suspected bladder lesion. Patients and Methods: Between April 2010 and June 2012, 152 patients above 50 years suffering from hematuria were included in this study. In all patients, ultrasound revealed a lesion suspected to be bladder cancer. Voided urine specimens were taken from all patients and transported to Pathology laboratory and processed within 1-3 h. All patients have undergone a cystoscopy examination and biopsy was taken from any suspicious lesion. The cytological diagnosis was reported as one of three categories, positive or negative or suspicious for malignancy. Results: One hundred thirty three (87.5%) patients in this study proved to have bladder carcinoma in histopathological examination. The sensitivity of UC was 53.4% and only five patients were suspicious. Percentage of positive cytology was highest among patients having gross hematuria (51.3%), posterior wall lesions (75%), papillonodular configuration (81.8%), invasive cancer (59.1%) and bilharzial affection (52.5%). Conclusion: Hematuria in patients older than 50 years with sonographically suspected bladder lesion mandates cystoscopy and biopsy. UC does not add more significant information in this group of patients.
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Affiliation(s)
- Hussam Eldin Helmy Mady
- Department of Pathology, Faculty of Medicine, Assiut University Hospital and School of Medicine, Assiut University, Egypt
| | - Abd Alhady Mohammad Omar
- Department of Pathology, Faculty of Medicine, Assiut University Hospital and School of Medicine, Assiut University, Egypt
| | - Mohamed Abd-Alla Elgammal
- Department of Urology, Faculty of Medicine, Assiut University Hospital and School of Medicine, Assiut University, Egypt
| | - Ghada Hosny Mohamed Ibrahim
- Department of Pathology, Faculty of Medicine, Assiut University Hospital and School of Medicine, Assiut University, Egypt
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Abstract
INTRODUCTION Bladder cancer ranks 4th overall in the number of newly diagnosed cancers and 10th in causes of cancer deaths. More than 90% of all cases of bladder cancer are transitional cell carcinoma (TCC). The goal of this study is to confirm the usefulness of low mechanical index contrast-enhanced ultrasonography (CEUS), also in association with time-intensity curves, in the differentiation between high- and low-grade bladder malignant lesions. MATERIALS AND METHODS From February 2006 to February 2012 we recruited 144 patients. All patients underwent grayscale ultrasonography (US), color-Doppler ultrasonography (CDUS) and contrast-enhanced ultrasonography (CEUS). Subsequently all patients underwent cystoscopy and TURB. RESULTS HISTOLOGICAL DIAGNOSES WERE: 88 high-grade carcinomas (61.1%), and 56 low-grade carcinomas (38.9%). Sensitivity and specificity of CDUS were 87.5% (126/144) and 60%, respectively. Sensitivity and specificity of CEUS were 90.9% and 85.7%, respectively. Sensitivity and specificity of TIC were 91.6% (132/144) and 85.7%, respectively. DISCUSSION AND CONCLUSIONS CEUS is a reliable noninvasive method for differentiating low- and high-grade bladder carcinomas since it provides typical enhancement patterns as well as specific contrast-sonographic perfusion curves.
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Affiliation(s)
- F M Drudi
- Department of Radiological Sciences, University "La Sapienza", Rome, Italy
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Hess J, Tschirdewahn S, Szarvas T, Rossi R, Rübben H, Vom Dorp F. [Urothelial carcinoma of the bladder: evaluation by combined endoscopy and urine cytology: is incontrovertible assessment possible?]. Urologe A 2011; 50:702-5. [PMID: 21465088 DOI: 10.1007/s00120-010-2502-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Transurethral resection of transitional cell carcinoma of the bladder provides a definitive surgical treatment and supplies tissue for histological evaluation. Superficial low-grade carcinomas with a small risk of progression are treated properly with fulguration alone. To justify fulguration as a definitive treatment of papillary bladder tumours, one must be able to safely distinguish low-grade, noninvasive tumours from those that are high grade and potentially invasive. MATERIAL AND METHODS A total of 160 patients with a transitional cell carcinoma at cystoscopy underwent transurethral resection of the tumour. The macroscopic appearance of the tumour, the aspect with bimanual palpation and the perioperative urine cytology were compared with the histological report. RESULTS In our study we were able to safely distinguish low-grade tumours from high-grade tumours. All noninvasive tumours could be identified visually as such. CONCLUSION Urologists skilled in the evaluation of urine cytology can distinguish low-grade noninvasive tumours of the bladder from high-grade and potentially invasive tumours by means of appearance at cystoscopy and perioperative urine cytology.
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Affiliation(s)
- J Hess
- Klinik für Urologie, Kinderurologie und Urologische Onkologie, Universitätsklinikum Essen, Hufelandstraße 55, 45122 Essen, Deutschland
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Francica G, Scarano F, Bellini S, Miragliuolo A. Prospective evaluation of interobserver diagnostic agreement for focal urinary bladder wall abnormalities detected by ultrasound. J Ultrasound 2011; 14:1-6. [DOI: 10.1016/j.jus.2010.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Nicolau C, Bunesch L, Peri L, Salvador R, Corral JM, Mallofre C, Sebastia C. Accuracy of contrast-enhanced ultrasound in the detection of bladder cancer. Br J Radiol 2010; 84:1091-9. [PMID: 21123306 DOI: 10.1259/bjr/43400531] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To assess the accuracy 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 ultrasound. METHODS 43 patients with suspected bladder cancer underwent conventional cystoscopy with transurethral biopsy of the suspicious lesions. 64 bladder 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 cancer detection and number of detected tumours were analysed and compared with the final diagnosis. RESULTS 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 ultrasound 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. CONCLUSION CEUS provided higher accuracy than baseline ultrasound for bladder cancer detection, being especially useful in non-conclusive baseline ultrasound studies.
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Affiliation(s)
- C Nicolau
- Diagnostic Imaging Center, Hospital Clinic, University of Barcelona, Barcelona, Spain.
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Qu X, Huang X, Wu L, Huang G, Ping X, Yan W. Comparison of virtual cystoscopy and ultrasonography for bladder cancer detection: a meta-analysis. Eur J Radiol 2010; 80:188-97. [PMID: 20452159 DOI: 10.1016/j.ejrad.2010.04.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 03/26/2010] [Accepted: 04/07/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND PURPOSE Bladder cancer is the most commonly diagnosed malignancy in patients presenting with haematuria. Early detection is crucial for improving patient prognosis. We therefore performed a meta-analysis to evaluate and compare the detection validity (sensitivity and specificity) of virtual cystoscopy (VC) and ultrasonography (US). METHODS We searched MEDLINE, EMBASE, PubMed and the Cochrane Library for studies evaluating diagnosis validity of VC and US between January 1966 and December 2009. Meta-analysis methods were used to pool sensitivity and specificity and to construct a summary receiver-operating characteristic (SROC) curve. RESULTS A total of 26 studies that included 3084 patients who fulfilled all of the inclusion criteria were considered for inclusion in the analysis. The pooled sensitivity for bladder cancer detection using CT virtual cystoscopy (CTVC), MR virtual cystoscopy (MRVC) and US was 0.939 (95% CI, 0.919-0.956), 0.908 (95% CI, 0.827-0.959) and 0.779 (95% CI, 0.744-0.812), respectively. The pooled specificity for bladder cancer detection using CTVC, MRVC and US was 0.981 (95% CI, 0.973-0.988), 0.948 (95% CI, 0.884-0.983) and 0.962 (95% CI, 0.953-0.969), respectively. The pooled diagnostic odd ratio (DOR) estimate for CTVC (604.22) were significantly higher than for MRVC (144.35, P<0.001) and US (72.472, P<0.001). CONCLUSION Our results showed that both CTVC and MRVC are better imaging methods for diagnosing bladder cancer than US. CTVC has higher diagnostic value (sensitivity, specificity and DOR) for the detection of bladder cancer than either MRCT or US.
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Affiliation(s)
- Xinhua Qu
- Department of Nuclear Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
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Puppo P, Conti G, Francesca F, Mandressi A, Naselli A. New Italian guidelines on bladder cancer, based on the World Health Organization 2004 classification. BJU Int 2010; 106:168-79. [PMID: 20346041 DOI: 10.1111/j.1464-410x.2010.09324.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To provide evidence-based recommendations on bladder cancer management METHODS A multidisciplinary guideline panel composed of urologists, medical oncologists, radiotherapists, general practitioners, radiologists, epidemiologists and methodologists conducted a structured review of previous reports, searching the Medline database from 1 January 2004 to 31 December 2008. The milestone papers published before January 2004 were accepted for analysis. The level of evidence and the grade of the recommendations were established using the GRADE system. RESULTS In all, 15 806 references were identified, 1940 retrieved, 1712 eliminated (specifying the reason for their elimination) and 971 included in the analysis, as well as 241 milestone reports. A consensus conference held to discuss the discrepancies between the scientific evidence and the clinical practice was then attended by 122 delegates of various specialities. CONCLUSION Recommendations on bladder cancer management are provided.
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Caruso G, Salvaggio G, Campisi A, Melloni D, Midiri M, Bertolotto M, Lagalla R. Bladder Tumor Staging: Comparison of Contrast-Enhanced and Gray-Scale Ultrasound. AJR Am J Roentgenol 2010; 194:151-6. [DOI: 10.2214/ajr.09.2741] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Nicolau C, Bunesch L, Sebastia C, Salvador R. Diagnosis of bladder cancer: contrast-enhanced ultrasound. ACTA ACUST UNITED AC 2009; 35:494-503. [PMID: 19458995 DOI: 10.1007/s00261-009-9540-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2009] [Accepted: 04/30/2009] [Indexed: 01/29/2023]
Affiliation(s)
- Carlos Nicolau
- Imaging Diagnosis Center, Hospital Clinic, University of Barcelona, Barcelona, Spain.
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