Giuseppe Caruso MD, Abstract Co-Author: Nothing to Disclose

Giuseppe Salvaggio MD, Presenter: Nothing to Disclose

Antonella Campisi MD, Abstract Co-Author: Nothing to Disclose

Fortunato Sorrentino MD, Abstract Co-Author: Nothing to Disclose

Massimo Midiri, Abstract Co-Author: Nothing to Disclose

Roberto Lagalla MD, Abstract Co-Author: Nothing to Disclose

To determine the role of contrast-enhanced sonography (CEUS) in the evaluation of bladder neoplasms.

16 patients with one or more exophytic bladder lesions detected with gray-scale sonography were prospectively examined by using second-harmonic US after bolus administration of 2.4 ml of a second-generation contrast agent (SonoVue). In case of multiple lesions the larger was examined. A triggered cine-loop of 1 minute was acquired. Time/intensity curves (TIC) were extracted from regions of interest positioned on the lesion and in the closer bladder wall. TIC shape qualitative analysis was performed. We also evaluated morphological findings at CEUS. All patients were submitted to transurethral resection or open cystectomy. At histology bladder lesions were classified according to 2004 WHO classification. CEUS findings were compared with pathology.

At histology 10/16 were classified as noninvasive urothelial neoplasias and 6/16 as infiltrating urothelial carcinoma. Two TICs shape were recognised; both had a wash-in phase followed by a plateau (A shape) or a wash-out (B shape) phase. Noninvasive neoplasias showed a A shape curve in all cases while infiltrating carcinoma had B shape curve in all cases. The presence of an hypoechoic layer between the lesion and closer bladder wall was observed in 8/10 noninvasive neoplasias while in 2/10, small lesions (diameter ≤1.5 cm), was not identifiable. The hypoechoic layer was not well appreciable in 4/6 cases and partially identified in 2/6 cases of infiltrating carcinoma.

The shape of TICs could allow to suppose biological behaviour of bladder lesions. Identification of an hypoechoic layer, if clearely visualized, could help to exclude wall infiltration.

Bladder cancer is the most common urothelial neoplasm. Correct treatment is conditioned by invasivity. CEUS allowing to suppose wall infiltration could address their correct management.

Caruso, G, Salvaggio, G, Campisi, A, Sorrentino, F, Midiri, M, Lagalla, R, Contrast-enhanced Ultrasound in the Evaluation of Bladder Neoplasms: Preliminary Results.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6017611.html