Technique | Description |
---|---|
CT | Mainstay of assessment in locally advanced and metastatic disease. Limitations are in assessing primary tumor. |
US | Two-dimensional techniques have no role in routine assessment of primary tumor, however presence of hydronephrosis is suggestive of MIBC. Contrast-enhanced and three-dimensional techniques are under investigation. |
MRI | Useful in identifying muscle-invasive and extravesical disease. Functional MRI currently under investigation as a predictive tumor biomarker. |
Virtual cystoscopy | Both CT and MRI data can be used to reconstruct bladder mucosa and simulate endoscopic evaluation. Unlike for other tumor sites such as GI, it is not used routinely. |
PET-CT | FDG-PET-CT not used as initial staging modality. Often used in conjunction with other imaging if uncertainly exists. FDG use for staging local disease limited predominantly by urinary excretion. Alternative isotopes and receptor specific molecules are under investigation. |