Common iliac, aortic, or inguinal nodes

More than 8 mm



Distant metastasis

Distant metastasis

Bladder tumors appear on US as echogenic lesions. The bladder wall has a more intense echo pattern than tumor tissue, thus permitting distinction of early superficial lesions from those invading the deeper layers of the bladder wall. However tumors involving the superficial muscle cannot be distinguished accurately from tumors involving the deep muscle (Table 2).

Trans-rectal and trans-urethral US carried out with a higher frequency transducer allow better resolution and better staging, but ventral tumors and tumors at the dome are poorly visualized.

Computed Tomography (CT)

The CT appearance of bladder tumors is not specific; it can simulate invasive carcinoma of the prostate or rectal metastasis, pheochromocytoma, Leiomyoma, lymphoma, and malakoplakia [62].

The major role of CT in bladder carcinoma is to stage, rather than to detect the primary tumor. This technique is less accurate in low stage tumors, and its reliability increases with more advanced disease [61] (Table 3).

Table 3. Accuracy of different staging techniques


Clinical staging including transurethral resection

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