Update in Imaging, staging and follow up of urinary tract cancer. The role of the radiologist.

Congress:

ECR 2020

Poster Number:

C-06779

Type:

Educational Exhibit

Keywords:

Not applicable, Neoplasia, Education, Ultrasound, MR, CT, Urinary Tract / Bladder, Oncology, Genitourinary

Authors:

M. M. Duh¹, J. C. Rodriguez Vicari², M. T. Fernandez³, N. Torra Ferrer³, M. Astaitie³, M. A. Barranco³, M. Manzano³, M. P. Abadal⁴; ¹La Garriga/ES, ²Barcelona /ES, ³Mataró/ES, ⁴Mataró ( Barcelona ) /ES

DOI:

10.26044/ecr2020/C-06779

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-06779

Fig. 1: Histological classification of bladder cancer.

Fig. 3: Schematic staging of bladder cancer.

Fig. 4: TNM Classification of Malignant Tumors. 8th edition. 2017.

Fig. 5: Schematic staging of upper UTC.

Learning objectives

To describe epidemiology, pathologic characteristics and patterns of tumour spread of the urinary tract carcinoma (UTC). To review nowadays used imaging techniques in diagnosis and follow up. To describe staging system.

Background

Epidemiology: UTC can be located in the lower (bladder and urethra) or the upper (pyelocaliceal cavities, renal pelvis and ureter) urinary tract. Bladder cancer (BC) is the most common urinary tract malignancy. It accounts for 90-95% of UTC. The worldwide incidence is 9.0 for men and 2.2 for women. The renal pelvis is the second most common site of this disease 8% approximately, followed by the distal, middle, proximal ureter and urethra (2%). A main characteristic of UTC is high rate of MULTIPLICITY and RECURRENCE....

Findings and procedure details

DIAGNOSIS: Assessment of BC begins with clinical examination, cytology, cystoscopy and biopsy revealing tumor type, grade and depth invasion. 2004/2016 WHO classification are used for tumor grading. There are three clinical relevant categories of BC with treatment implications: -Non muscle-invasive bladder cancer (Ta, CIS and T1) (NMIBC). Represents most patients with BC (75%), low grade more frequent. - Muscle-Invasive Bladder Cancer Non metastatic (T2 and above) (MIBC). -Metastatic disease: 4% of incidence. Imaging modalities play irreplaceable role in detecting methacronic disease and staging. They are...

Conclusion

Staging determinates prognostic and identifies appropriate treatment options. Theaccuracy inBC tumour staging is still low with CTU and MRI. The radiologist plays an irreplaceable role in the interpretation of images and should include new developing functional imaging methods, combine them with conventional procedures, participate in research and interact with oncologysts, surgeons pathologists and to achieve better results.

Personal information and conflict of interest

M. M. Duh; Mataró/ES - Author at Hospital de Mataró - Speaker at Hospital de Mataró J. C. Rodriguez Vicari; Barcelona/ES - nothing to disclose M. T. Fernandez; Mataró/ES - nothing to disclose M. Manzano; Mataró/ES - nothing to disclose M. A. Barranco; Mataró/ES - nothing to disclose N. Torra Ferrer; Mataró/ES - nothing to disclose M. Astaitie; Mataró/ES - nothing to disclose M. P. Abadal; Mataró ( Barcelona )/ES - nothing to disclose

References

Raghunandan Vikram et al.(2009) Imaging and Staging of Transitional Cell Carcinoma: Part 2, Upper Urinary. Tract AJR.192:1488–1493 Jooae Choe et al.(2017) Updates for the radiologist in non-muscleinvasive, muscle-invasive, and metastatic bladder cancer. Abdom Radiol.42(11):2710-2724. Valeria Panebianco et al.(2018) Multiparametric Magnetic Resonance Imaging for Bladder Cancer: Development of VI-RADS.Eur Urol.74(3): 294–306. Siva P. Raman et al.(2016).Upper and Lower Tract Urothelial Imaging Using Computed Tomography Urography.Radiol Clin N Am. Shaista Hafeez, Robert Hudart (2013) Advances in bladder cancer imaging. BMC Medicine. 11:104. European Asociation of Urology.https://uroweb.org/guideline/non-muscle-invasive-bladder-cancer/ European...