COMPARISON OF COMPUTED TOMOGRAPHY WITH CYSTOSCOPY IN EARLY DETECTION OF URINARY BLADDER TUMORS

Abstract

Background:
Bladder cancer is a popular urinary tract malignancy, which can easily manifest itself through hematuria and should be identified as soon as possible to be treated more successfully. Although the gold standard of diagnosis has been cystoscopy, it is embarrassing and painful to the patient. Combined with computed tomography (CT), there is a non-invasive option that is able to evaluate the tumor size, location, and extravesical spread.

Aim of the Study:

To compare computed tomography and cystoscopy in early detection of urinary bladder tumors

Methodology:
The present study was a cross-sectional study that involved 80 suspected patients of affected bladder tumors. CT and cystoscopic examination were done on all the patients. Tumor features such as number, size, margins, location and surrounding extension were noted. Data analysis of sensitivity and specificity, positive and negative predictive value, Kappa agreement and statistical comparison were conducted with McNemar and Chi-square tests using SPSS 27.0.

Results:
Among 80 patients, 64 (80%) were CT-positive and 60 (75%) were cystoscopy-positive. CT demonstrated sensitivity of 90% and specificity of 50%, while cystoscopy had sensitivity of 87% and specificity of 95%. Kappa agreement was 0.429, indicating moderate concordance. McNemar test showed no significant difference between modalities (p = 0.454). CT detected perivesical extension in 35% of cases and identified tumors >3 cm with irregular margins effectively, whereas small or flat lesions were better detected on cystoscopy.

Conclusion:
CT shows high sensitivity and reasonable agreement with cystoscopy, especially for medium and large tumors, and can serve as a reliable non-invasive adjunct. Cystoscopy remains essential for detecting small or early-stage tumors. Together, CT and cystoscopy complement each other for accurate diagnosis, staging, and management planning.