Ultrasonographic Assessment of Bladder Tumors. II. Clinical Staging

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Abstract
Uniformity of the echo return from bladder wall has been demonstrated in experimental and patient studies. An infiltrating bladder tumor disrupts this uniformity. The studies showed a sharp bladder wall outline that was less echogenic, probably representing the perivesical fat. The ultrasonographic estimation of tumor staging was related to the depth of infiltration of the bladder wall. A staging accuracy of nearly 100% was found for deep tumors of the bladder wall or those penetrating extravesical structures. Many superficial tumors were overstaged, their staging accuracy being only slightly higher than 55%. In view of its accuracy in staging infiltrating tumors in addition to its other advantages, ultrasound seems to be the method of choice in preoperative staging of tumors. It should be included in the routine protocol and should follow diagnostic cystoscopy in all cases of tumors larger than 0.5 cm.