ACR Appropriateness Criteria® Pretreatment Staging of Muscle-Invasive Bladder Cancer Journal Article


Authors: van der Pol, C. B.; Sahni, V. A.; Eberhardt, S. C.; Oto, A.; Akin, O.; Alexander, L. F.; Allen, B. C.; Coakley, F. V.; Froemming, A. T.; Fulgham, P. F.; Hosseinzadeh, K.; Maranchie, J. K.; Mody, R. N.; Schieda, N.; Schuster, D. M.; Venkatesan, A. M.; Wang, C. L.; Lockhart, M. E.
Article Title: ACR Appropriateness Criteria® Pretreatment Staging of Muscle-Invasive Bladder Cancer
Abstract: Muscle-invasive bladder cancer (MIBC) has a tendency toward urothelial multifocality and is at risk for local and distant spread, most commonly to the lymph nodes, bone, lung, liver, and peritoneum. Pretreatment staging of MIBC should include imaging of the urothelial upper tract for synchronous lesions; imaging of the chest, abdomen, and pelvis for metastases; and MRI pelvis for local staging. CT abdomen and pelvis without and with contrast (CT urogram) is recommended to assess the urothelium and abdominopelvic organs. Pelvic MRI can improve local bladder staging accuracy. Chest imaging is also recommended with chest radiograph usually being adequate. FDG-PET/CT may be appropriate to identify nodal and metastatic disease. Chest CT may be useful in high-risk patients and those with findings on chest radiograph. Nonurogram CT and MRI of the abdomen and pelvis are usually not appropriate, and neither is radiographic intravenous urography, Tc-99m whole body bone scan, nor bladder ultrasound for pretreatment staging of MIBC. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. © 2018 American College of Radiology
Keywords: staging; bladder cancer; urothelial carcinoma; ct; mri; appropriateness criteria; auc; muscle-invasive bladder cancer; appropriate use criteria
Journal Title: Journal of the American College of Radiology
Volume: 15
Issue: 5 Suppl.
ISSN: 1546-1440
Publisher: Elsevier Science, Inc.  
Date Published: 2018-05-01
Start Page: S150
End Page: S159
Language: English
DOI: 10.1016/j.jacr.2018.03.020
PROVIDER: scopus
PUBMED: 29724418
DOI/URL:
Notes: Article -- Authors are part of the panel: "Expert Panel on Urologic Imaging" -- Export Date: 1 June 2018 -- Source: Scopus
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  1. Oguz Akin
    272 Akin
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