Prospective evaluation of 4-D contrast-enhanced-ultrasound (CEUS) imaging in bladder tumors

Issue title: Selected post-conference papers of the 38th Conference of the German Society for Clinical Microcirculation and Hemorheology, 21-23 November 2019, Braunschweig, Germany

Guest editors: P. Wiggermann, A. Krüger-Genge and F. Jung

Article type: Research Article

Authors: Jokisch, F.^{a; *} | Buchner, A.^a | Schulz, G.B.^a | Grimm, T.^a | Weinhold, P.^a | Pfitzinger, P.L.^a | Chaloupka, M.^a | Stief, C.G.^a | Schlenker, B.^a | Clevert, D.-A.^b

Affiliations: [a] Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany | [b] Department of Clinical Radiology, Interdisciplinary Ultrasound-Center, University Hospital Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany

Correspondence: [*] Corresponding author: Dr. med. F. Jokisch, M.D., Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377 Munich, Germany. Tel.: +49 89 44007 2971; Fax: +49 89 44007 8890; E-mail: Friedrich.Jokisch@med.uni-muenchen.de.

Abstract: PURPOSE:The evaluation of the potential clinical benefit of four-dimensional ultrasound (4D-US) in the assessment of bladder cancer (BC). MATERIAL AND METHODS:20 patients with indication for cystoscopy for suspicion of bladder cancer were prospectively included in this study. All patients underwent two-dimensional ultrasound (2D-US), contrast enhanced ultrasound (CEUS) and real-time four-dimensional ultrasound (4D-US). All acquisitions were compared to each other in regard to image quality. This assessment was done using a 6 point scale (1 = best). All patients underwent subsequently cystoscopy with resection of the tumor (TURB), due a histopathological analysis was possible. RESULTS:All examinations were performed successfully and no patient had to be excluded from the study. Patients acceptance of 4D-US was consistently good. No adverse events occurred. Image quality of real time 4D-US (score: 1.27±0.46) was significantly superior (p < 0.001) to both, conventional 2D-US (score: 2.33±0.62) and also to 2D-CEUS (score: 2.00±0.53). In terms of tumor detection no superiority was evident for 4D-US compared to 2D-US or in utilization of CEUS (sensitivity = 0.89; specificity = 1.00; positive predictive value = 1.00; negative predictive value = 0.50; AUC = 0.944; (95% CI: 07.43–0.998)). CONCLUSION:The assessment of bladder cancer using real time 4D-US is feasible and improves the image quality and therefore also the precise anatomical consistency of intravesical tumor masses.

Keywords: Bladder cancer detection, real-time 4D ultrasound, four-dimensional ultrasound of the bladder, ultrasound of bladder cancer

DOI: 10.3233/CH-199231

Journal: Clinical Hemorheology and Microcirculation, vol. 74, no. 1, pp. 1-12, 2020