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BMC Urology

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Open Access 01-12-2024 | Urothelial Cancer | Research

Quantitative differentiation of non-invasive bladder urothelial carcinoma and inverted papilloma based on CT urography

Authors: Pengfei Jin, Liqin Yang, Yitao Liu, Jiehui Huang, Xu Wang

Published in: BMC Urology | Issue 1/2024

Abstract

Purpose

To investigate the value of CT urography (CTU) indicators in the quantitative differential diagnosis of bladder urothelial carcinoma (BUC) and inverted papilloma of the bladder (IPB).

Material and methods

The clinical and preoperative CTU imaging data of continuous 103 patients with histologically confirmed BUC or IPB were retrospectively analyzed. The imaging data included 6 qualitative indicators and 7 quantitative measures. The recorded clinical information and imaging features were subjected to univariate and multivariate logistic regression analysis to find independent risk factors for BUC, and a combined multi-indicator prediction model was constructed, and the prediction model was visualized using nomogram. ROC curve analysis was used to calculate and compare the predictive efficacy of independent risk factors and nomogram.

Results

Junction smoothness, maximum longitudinal diameter, tumor-wall interface and arterial reinforcement rate were independent risk factors for distinguishing BUC from IPB. The AUC of the combined model was 0.934 (sensitivity = 0.808, specificity = 0.920, accuracy = 0.835), and its diagnostic efficiency was higher than that of junction smoothness (AUC=0.667, sensitivity = 0.654, specificity = 0.680, accuracy = 0.660), maximum longitudinal diameter (AUC=0.757, sensitivity = 0.833, specificity = 0.604, accuracy = 0.786), tumor-wall interface (AUC=0.888, sensitivity = 0.755, specificity = 0.808, accuracy = 0.816) and Arterial reinforcement rate (AUC=0.786, sensitivity = 0.936, specificity = 0.640, accuracy = 0.864).

Conclusion

Above qualitative and quantitative indicators based on CTU and the combination of them may be helpful to the differential diagnosis of BUC and IPB, thus better assisting in clinical decision-making.

Key points

1. Bladder urothelial carcinoma (BUC) and inverted papilloma of the bladder (IPB) exhibit similar clinical symptoms and imaging presentations.

2. The diagnostic value of CT urography (CTU) in distinguishing between BUC and IPB has not been documented.

3. BUC and IPB differ in lesion size, growth pattern and blood supply.

4. The diagnostic efficiency is optimized by integrating multiple independent risk factors into the prediction model.

Antoni S, Ferlay J, Soerjomataram I, et al. Bladder cancer incidence and mortality: a global overview and recent trends. Eur Urol. 2017;71(1):96–108. https://doi.org/10.1016/j.eururo.2016.06.010.CrossRefPubMed

Richters A, Aben KKH, Kiemeney LALM. The global burden of urinary bladder cancer: an update. World J Urol. 2020;38(8):1895–904. https://doi.org/10.1007/s00345-019-02984-4.CrossRefPubMed

Ho L, Jones E, Kavanagh A. Benign inverted papilloma at bladder neck causing acute urinary retention. J Surg Case Rep. 2018;6:125. https://doi.org/10.1093/jscr/rjy125.CrossRef

Taylor J, Becher E, Steinberg GD. Update on the guideline of guidelines: non-muscle-invasive bladder cancer. BJU Int. 2020;125(2):197–205. https://doi.org/10.1111/bju.14915.CrossRefPubMed

Mitra AP, Cai J, Miranda G, et al. Management trends and outcomes of patients undergoing radical cystectomy for urothelial carcinoma of the bladder: evolution of the University of Southern California Experience over 3,347 Cases. J Urol. 2022;207(2):302–13. https://doi.org/10.1097/JU.0000000000002242.CrossRefPubMed

Rouprêt M, Seisen T, Birtle AJ, et al. European association of urology guidelines on upper urinary tract urothelial carcinoma: 2023 update. Eur Urol. 2023;S0302–2838(23):02652. https://doi.org/10.1016/j.eururo.2023.03.013.CrossRef

Baarimah A, El Helaly A, Al Ghanbar M, et al. Inverted urothelial papilloma: a rare pathology in young girl. A case report and literature review. Urol Case Rep. 2020;35:101543. https://doi.org/10.1016/j.eucr.2020.101543.CrossRefPubMedPubMedCentral

Paner GP, Montironi R, Amin MB. Challenges in pathologic staging of bladder cancer: proposals for fresh approaches of assessing pathologic stage in light of recent studies and observations pertaining to bladder histoanatomic variances. Adv Anat Pathol. 2017;24(3):113–27. https://doi.org/10.1097/PAP.0000000000000152.CrossRefPubMed

Akgul M, MacLennan GT, Cheng L. Distinct mutational landscape of inverted urothelial papilloma. J Pathol. 2019;249(1):3–5. https://doi.org/10.1002/path.5307.CrossRefPubMed

10.

Van Der Molen AJ, Cowan NC, Mueller-Lisse UG, et al. CT urography: definition, indications and techniques. A guideline for clinical practice. Eur Radiol. 2008;18(1):4–17. https://doi.org/10.1007/s00330-007-0792-x.CrossRefPubMed

11.

Flaig TW, Spiess PE, Agarwal N, et al. Bladder Cancer, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2020;18(3):329–54. https://doi.org/10.6004/jnccn.2020.0011.CrossRefPubMed

12.

Cumberbatch MGK, Foerster B, Catto JWF, et al. Repeat Transurethral Resection in Non-muscle-invasive Bladder Cancer: A Systematic Review. Eur Urol. 2018;73(6):925–33. https://doi.org/10.1016/j.eururo.2018.02.014.CrossRefPubMed

13.

Picozzi S, Casellato S, Bozzini G, et al. Inverted papilloma of the bladder: a review and an analysis of the recent literature of 365 patients. Urol Oncol. 2013;31(8):1584–90. https://doi.org/10.1016/j.urolonc.2012.03.009.CrossRefPubMed

14.

Takeuchi M, Sasaguri K, Naiki T, et al. MRI findings of inverted urothelial papilloma of the bladder. AJR Am J Roentgenol. 2015;205(2):311–6. https://doi.org/10.2214/AJR.14.13879.CrossRefPubMed

15.

Trinh TW, Glazer DI, Sadow CA, et al. Bladder cancer diagnosis with CT urography: test characteristics and reasons for false-positive and false-negative results. Abdom Radiol (NY). 2018;43(3):663–71. https://doi.org/10.1007/s00261-017-1249-6.CrossRefPubMed

16.

Li L, Na R, Mi T, et al. Medical image diagnostic value of computed tomography for bladder tumors. Comput Math Methods Med. 2021;2021:3781028. https://doi.org/10.1155/2021/3781028.CrossRefPubMedPubMedCentral

17.

Raman SP, Fishman EK. Bladder malignancies on CT: the underrated role of CT in diagnosis. AJR Am J Roentgenol. 2014;203(2):347–54. https://doi.org/10.2214/AJR.13.12021.CrossRefPubMed

18.

Jørgensen PH, Vainer B, Hermann GG. A clinical and molecular review of inverted papilloma of the urinary tract: how to handle? APMIS. 2015;123(11):920–9. https://doi.org/10.1111/apm.12456.CrossRefPubMed

19.

Asano K, Miki J, Maeda S, et al. Clinical studies on inverted papilloma of the urinary tract: report of 48 cases and review of the literature. J Urol. 2003;170(4 Pt 1):1209–12. https://doi.org/10.1097/01.ju.0000085342.15918.d7.CrossRefPubMed

20.

Sweeney MK, Rais-Bahrami S, Gordetsky J. Inverted urothelial papilloma: a review of diagnostic pitfalls and clinical management. Can Urol Assoc J. 2017;11(1–2):66–9. https://doi.org/10.5489/cuaj.4136.CrossRefPubMedPubMedCentral

21.

Ozden E, Turgut AT, Yesil M, et al. A new parameter for staging bladder carcinoma: ultrasonographic contact length and height-to-length ratio. J Ultrasound Med. 2007;26(9):1137–42. https://doi.org/10.7863/jum.2007.26.9.1137.CrossRefPubMed

22.

Huele EH, Veenboer PW, Wessels FJ, et al. Value of multiparametric magnetic resonance imaging for local staging of invasive urinary bladder tumours. Urol Oncol. 2023;41(1):49.e7-49.e12. https://doi.org/10.1016/j.urolonc.2022.09.026.CrossRefPubMed

23.

Arita Y, Shigeta K, Akita H, et al. Clinical utility of the Vesical Imaging-Reporting and Data System for muscle-invasive bladder cancer between radiologists and urologists based on multiparametric MRI including 3D FSE T2-weighted acquisitions. Eur Radiol. 2021;31(2):875–83. https://doi.org/10.1007/s00330-020-07153-5.CrossRefPubMed

24.

Ahn H, Hwang SI, Lee HJ, et al. Quantitation of bladder cancer for the prediction of muscle layer invasion as a complement to the vesical imaging-reporting and data system. Eur Radiol. 2021;31(3):1656–66. https://doi.org/10.1007/s00330-020-07224-7.CrossRefPubMed

25.

Feng SH, Yang ST. The new 8th TNM staging system of lung cancer and its potential imaging interpretation pitfalls and limitations with CT image demonstrations. Diagn Interv Radiol. 2019;25(4):270–9. https://doi.org/10.5152/dir.2019.18458.CrossRefPubMedPubMedCentral

26.

Shieh AC, Guler E, Ojili V, et al. Extraprostatic extension in prostate cancer: primer for radiologists. Abdom Radiol (NY). 2020;45(12):4040–51. https://doi.org/10.1007/s00261-020-02555-x.CrossRefPubMed

27.

Fu W, Liu D, Xiong Y, et al. The comparison between contrast-enhanced ultrasound and contrast-enhanced magnetic resonance imaging in diagnosing bladder urothelial carcinoma. Int Urol Nephrol. 2023;55(5):1073–9. https://doi.org/10.1007/s11255-022-03410-2.CrossRefPubMed

28.

Zhu J, Huang X, Liu L, Wang N, Nie F. Can the Vesical Imaging Reporting and Data System (VI-RADS) score be applied in conventional ultrasound and contrast-enhanced ultrasound to differentiate muscle-invasive bladder cancer? Med Ultrason. 2023;25(1):22–8. https://doi.org/10.11152/mu-3841.

29.

Kobayashi Y, Hashimoto S, Ishikawa S, et al. Nihon Hinyokika Gakkai Zasshi. 1992;83(12):2037-2043. https://doi.org/10.5980/jpnjurol1989.83.2037.

30.

Panebianco V, De Berardinis E, Barchetti G, et al. An evaluation of morphological and functional multi-parametric MRI sequences in classifying non-muscle and muscle invasive bladder cancer. Eur Radiol. 2017;27(9):3759–66. https://doi.org/10.1007/s00330-017-4758-3.CrossRefPubMed

31.

Sarier M, Usta SS, Turgut H, et al. Prognostic value of HPV DNA in urothelial carcinoma of the bladder: a preliminary report of 2-year follow-up results. Urol J. 2021;19(1):45–9. https://doi.org/10.22037/uj.v18i.6429.CrossRefPubMed

Title: Quantitative differentiation of non-invasive bladder urothelial carcinoma and inverted papilloma based on CT urography
Authors: Pengfei Jin
Liqin Yang
Yitao Liu
Jiehui Huang
Xu Wang
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Urothelial Cancer
Urothelial Cancer
Urography
Published in: BMC Urology / Issue 1/2024
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-024-01459-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quantitative differentiation of non-invasive bladder urothelial carcinoma and inverted papilloma based on CT urography

Abstract

Purpose

Material and methods

Results

Conclusion

Key points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Material and methods

Results

Conclusion

Key points

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