technetium-tc-99m-sulfur-colloid and Urinary-Bladder-Neoplasms

The role of ultrasonography, computed tomography (CT), and radioisotopic scanning in the staging of bilharzial bladder cancer has not been reported previously. Forty patients with invasive bladder cancer seen at the King Faisal Specialist Hospital and Research Centre between January 1978 and June 1981 underwent complete preoperative workup for staging of their tumors prior to radical cystectomy. The preoperative radiologic investigations included excretory urography (IVP), ultrasonography (US), CT of the pelvis, and liver and bone scans. The results of these investigations were compared with the operative and pathologic staging. Ninety-three percent of the patients with bilharzial cancer had evidence of ureteric obstruction on IVP compared with 22% of the nonbilharzial cancer patients. The presence of ureteric obstruction in these patients did not correlate with the stage of the disease with 83% of the patients with superficial tumors (T1 and T2) having hydroureteronephrosis. Ultrasonography and CT had an 83% accuracy in the staging of superficial tumors. Stage T3 tumors were understaged in 14% of the cases. Ultrasonography did not differentiate Stages T3 and T4 tumors while CT scan differentiated these two stages in 57% of the cases. Bone scan failed to reveal evidence of metastatic disease in any of the bilharzial cancer patients. Liver scan was suspicious for liver metastases in two patients with bilharzial cancers in whom open liver biopsy revealed only hepatic bilharziasis. Of all the radiographic studies, US or preferably CT scan seem to be of some value in the staging of bilharzial tumors localized to the bladder. Bone and liver scans are probably of no cost effective benefit.

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Diphosphonates; Humans; Liver Neoplasms; Middle Aged; Neoplasm Staging; Prognosis; Radionuclide Imaging; Schistosomiasis; Sulfur; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography; Urinary Bladder Neoplasms; Urography

To evaluate the cost-effectiveness of liver and bone isotope scans results were reviewed in 114 patients with invasive transitional cell carcinoma of the bladder. In 100 patients cystectomy was performed. In no patient has the results of the scans influenced or changed treatment. Routine use of isotope scans is not warranted for the preoperative evaluation of bladder cancer patients.

Topics: Bone and Bones; Bone Neoplasms; Carcinoma, Transitional Cell; Cost-Benefit Analysis; Female; Humans; Liver; Liver Neoplasms; Male; Preoperative Care; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Urinary Bladder Neoplasms