To evaluate the difference in the CT staging of bladder tumor with or without distortion of the bladder wall, we have retrospectively reviewed. CT images of 48 patients with histologically proven transitional cell carcinoma. All subjects were
identified whether distortion of the bladder wall was present or not. On CT staging of bladder tumor, a pedunculated tumor was classified as Ta or T1 a sessile tumor as T2, a sessile tumor with thickened wall as T3a, obliteration of the boundary between bladder wall and perivesical fat as T3b, and an invasion of adjacent organ as T4. Distortion of the bladder wall was demonstrated in 25 cases out of a total 48 cases. With pathologic staging, distortion was detected in 7 of cases(39% ) in pTa/pT1, 3 of 7 cases(43%) in pT2, 3 of 4 cases(75%) in pT3a, 9 of 14 cases(64%) in pT3b, and 3 and of 5 cases(60%) in pT4 respectively. The results of pathologic staging were graded according to the TNM system. The surgical and pathologic findings were correlated with the CT findings. The accuracy of CT staging of bladder tumor was 60%(15/48) with distortion and 61%(14/48) without distortion. In the presence of distortion, overstaging was 16%(4/25) and understaging was 24%) (6/25)while in cases of without distortion, 9%(2/23) was overstaged and 30%(7/23) was understaged.
In conclusion, advanced stages in bladder carcinoma show distortion of the bladder wall more frequently and significantly but distortion were sometimes noted in pTa/T1. We should carefully determine CT staging of bladder tumor because of a
possible overstaging in case of distortion of the bladder wall.
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