Diagnostic Accuracy of Computed Tomography and Magnetic Resonance Urography in Detection of Bladder Tumors taking Histopathology as Gold Standard in Patients presenting with Hematuria at Tertiary Care Hospital Karachi

Abstract

Objective: To compare the computed tomography urography and magnetic resonance urography in the diagnosis of bladder tumors in patients who present with hematuria using the histopathology as reference standard.

Study Design: Cross sectional diagnostic accuracy study
Place and Duration of Study: This study was conducted at the Department of Radiology, Sindh Institute of Urology and Transplantation, Karachi from 1st February 2022 to 1st 31st July 2022.

Methods: 356 patients presented to the with hematuria were enrolled. Eligible patients were subjected to a computed tomography ureography and magnetic resonance ureography and the findings compared to the
histopathological diagnosis. Sensitivity, specificity, positive predictive value and negative predictive value and overall diagnostic accuracy of both imaging modalities were calculated.

Results: The mean age was 59.23±8.41 years and the mean duration of symptoms was 2.14±0.89 weeks. One hundred and eighty seven (52.5%) were males and 169 (47.5%) were females. Magnetic resonance urography
sensitivity was 80.0%, specificity 99.0%, positive predictive value 93.6%, negative predictive value 96.4% and diagnostic accuracy 96.0%. By contrast, computed tomography urography had a sensitivity of 63.6%, specificity of
95.0%, positive predictive value of 70.0%, negative predictive value of 93.4% and diagnostic accuracy of 90.1%. Magnetic resonance urography was thus more sensitive and was overall more accurate to detect bladder tumors than computed tomography urography.

Conclusion: Computed tomography urography was good for detecting bladder tumors in patients with hematuria compared to magnetic resonance urography. Magnetic resonance urography however was more sensitive, specific and had a higher overall diagnostic accuracy than magnetic resonance urography when compared with histopathology as a reference standard.