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Role of Whole-Body Staging Computed Tomographic Scans for Detecting Distant Metastases in Patients With Bladder Cancer

Rajesh, Arumugam MBBS, FRCR*; Sokhi, Heminder FRCR*; Fung, Rachael MBBS, BSc*; Mulcahy, Kevin A. FRCR*; Bankart, Michael J.G.

Journal of Computer Assisted Tomography: May-June 2011 - Volume 35 - Issue 3 - p 402-405
doi: 10.1097/RCT.0b013e318214ad58
Whole Body Imaging

Objective: This study aimed to establish the incidence of distant metastases on whole-body computed tomographic (CT) scans in patients with newly diagnosed bladder cancer and to determine whether there is a significant difference in the incidence of metastases in patients with superficial and muscle invasive cancers.

Materials and Methods: A total of 201 patients who had a proven histological diagnosis of transitional cell carcinoma of the bladder and a whole-body staging CT scan at diagnosis were identified from our MDT database during a 36-month period. Imaging was retrospectively reviewed with view to recording site, if any, of distant metastases.

Results: Of 201 patients, 11 (5.5%) were found to have distant metastases on CT. In univariable models, staging was not associated with either age (odds ratio, 0.98; 95% confidence interval, 0.92-1.04; P = 0.4) or sex (Fisher exact test, P = 0.07). Mean (SD) age was 74.1 (10.5) years. There was a significant association between staging and metastasis (odds ratio, 19.9; 95% confidence interval, 3.2-infinity; P = 0.0003). Of the patients, 7% of males had metastases versus 0% of the females.

Conclusions: Staging CT scans for assessment of distant metastatic disease in patients with newly diagnosed bladder cancer can be restricted to patients with muscle invasive disease.

From the *Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester General Hospital; and †Department of Health Sciences, University of Leicester, Leicester, UK.

Received for publication August 4, 2010; accepted January 7, 2011.

Reprints: Arumugam Rajesh, MBBS, FRCR, Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Rd, Leicester. LE54PW (e-mail:

No funding was obtained from the National Institutes of Health, Wellcome Trust, or Howard Hughes Medical Institute.

© 2011 Lippincott Williams & Wilkins, Inc.