Desencia E. Thomas, MD, presented “Updates on the Imaging for Urothelial Carcinoma” during the 28th Annual Innovations in Urologic Practice conference on September 22, 2024, in Denver, Colorado.
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How to cite: Thomas, Desencia E. “Updates on the Imaging for Urothelial Carcinoma.” September 22, 2024. Accessed Nov 2024. https://grandroundsinurology.com/updates-on-the-imaging-for-urothelial-carcinoma/
Updates on the Imaging for Urothelial Carcinoma – Summary
Desencia E. Thomas, MD, presents an update on imaging techniques for urothelial carcinoma (UC), emphasizing advancements in diagnosis and staging.
In this 18-minute presentation, Dr. Thomas highlights the diagnostic accuracy of CT urography. MR urography provides an alternative for patients unable to tolerate iodine-based contrast or when CT findings are inconclusive. PET imaging, including 18-F FDG PET, excels in detecting distant metastases, but tracers like 11-C acetate and choline help minimize false positives in the urinary tract due to reduced excretion.
Dr. Thomas discusses the role of MRI in bladder cancer staging, where VI-RADS scoring helps distinguish between muscle-invasive and non-invasive cancers. This system, using T2-weighted, diffusion-weighted, and contrast-enhanced sequences, enables precise preoperative staging. Dual-energy CT (DECT) is also emerging, allowing reduced radiation exposure while retaining diagnostic value.
Key challenges include limited imaging sensitivity for early-stage UC and difficulty assessing tumor invasion depth. Dr. Thomas emphasizes that contrast-enhanced ultrasound may assist patients with contraindications to CT or MRI, although it remains less sensitive for upper tract tumors. She stresses that imaging advancements hold promise for improving UC management and minimizing invasive procedures like TURBT.
About The 28th Annual Innovations in Urologic Practice:
Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma; men’s health topics like male infertility, andrology, and sexual dysfunction; OAB and voiding dysfunctions; and ways to diagnose and treat infections in the urology patient.
For further educational activities from this conference, visit our collection page.