Clinical and Translational Imaging

, Volume 6, Issue 4, pp 257–269 | Cite as

A glance at imaging bladder cancer

  • Ebru Salmanoglu
  • Ethan Halpern
  • Eduoard J. Trabulsi
  • Sung Kim
  • Mathew L. Thakur
Systematic Review
Part of the following topical collections:
  1. Genitourinary



Early and accurate diagnosis of bladder cancer (BCa) will contribute extensively to the management of the disease. The purpose of this review was to briefly describe the conventional imaging methods and other novel imaging modalities used for early detection of BCa and outline their pros and cons.


Literature search was performed on Pubmed, PMC, and Google scholar for the period of January 2014 to February 2018 and using such words as “bladder cancer, bladder tumor, bladder cancer detection, diagnosis and imaging”.


A total of 81 published papers were retrieved and are included in the review. For patients with hematuria and suspected of BCa, cystoscopy, and CT are most commonly recommended. Ultrasonography, MRI, PET/CT using 18F-FDG, or 11C-choline and recently PET/MRI using 18F-FDG also play a prominent role in detection of BCa.


For initial diagnosis of BCa, cystoscopy is generally performed. However, cystoscopy cannot accurately detect carcinoma in situ and cannot distinguish benign masses from malignant lesions. CT is used in two modes, CT and computed tomographic urography, both for diagnosis and for staging of BCa. However, they cannot differentiate T1 and T2 BCa. MRI is performed to diagnose invasive BCa and can differentiate muscle invasive bladder carcinoma from non-muscle invasive bladder carcinoma. However, CT and MRI have low sensitivity for nodal staging. For nodal staging, PET/CT is preferred. PET/MRI provides a better differentiation of normal and pathologic structures as compared with PET/CT. Nonetheless none of the approaches can address all issues related for the management of BCa. Novel imaging methods that target specific biomarkers, image BCa early and accurately, and stage the disease are warranted.


Bladder cancer Imaging Cancer diagnosis CT MRI PET/CT 



Apparent diffusion coefficient


American urological association


Bladder cancer




Contrast-enhanced ultrasonography


Contrast-enhanced computed tomography


Carcinoma in situ


Confocal laser endomicroscopy


Corticomedullary phase


Cumulative incidence of cancer-specific death


Computed tomography


Computed tomographic urography


Two-dimensional ultrasonography


Dynamic contrast-enhanced magnetic resonance imaging


Diffusion-weighted magnetic resonance imaging


Flexible cystoscopy




False positive


Histological T staging


Lymph node


Lymphotropic nanoparticle enhanced MRI


Multiparametric MRI


Magnetic resonance imaging


Magnetic resonance urography


Normalized ADC


Sodium fluoride


Narrow band imaging


National comprehensive cancer network


Non-muscle invasive bladder cancer


Muscle invasive bladder cancer


Negative predictive value


Optical coherence tomography


Overall survival


Radical cystectomy


Photodynamic diagnosis


Positron emission tomography/computed tomography


Positron emission tomography/magnetic resonance imaging


Positive predictive value


Storz professional image enhancement system


Maximum standardized uptake value

1.5 T

1.5 Tesla

3 T

3 Tesla


Transurethral resection of bladder


T1-weighted magnetic resonance imaging


T2-weighted magnetic resonance imaging


Ultrasound T staging




White light cystoscopy



Dr. Thakur (PI), thanks NIH/NCI RO1CA157372, Deans Translational Science Award and the Sidney Kimmel Cancer Center Research award for their support in part. Dr. Ebru Salmanoglu is the visiting scholar to the Thakur laboratories and thanks The Scientific and Technological Research Council of Turkey (TÜBİTAK) for their fellowship.

Compliance with ethical standards

Conflict of interest

The authors Ebru Salmanoglu, Ethan Halpern, Edouard J. Trabulsi, Sung Kim, and Mathew L. Thakur have no of conflicts of interest.


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Copyright information

© Italian Association of Nuclear Medicine and Molecular Imaging 2018

Authors and Affiliations

  • Ebru Salmanoglu
    • 1
  • Ethan Halpern
    • 2
  • Eduoard J. Trabulsi
    • 2
  • Sung Kim
    • 2
  • Mathew L. Thakur
    • 2
  1. 1.Kahramanmaras Sutcu Imam UniversityKahramanmarasTurkey
  2. 2.Thomas Jefferson UniversityPhiladelphiaUSA

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