Cancer - Bladder, Pelvis, Ureter & Others(구연) (E-067) 비침습적 검사를 통하여 근육 비침습 방광암의 추적 관찰이 가능한가? 연세의대 신촌세브란스병원 비뇨의학교실 이종수, 조영흔, 박지수, 허지은, 장원식, 함원식, 최영득¹ Purpose Bladder cancer has a high recurrence rate; therefore, frequent follow-up is required. Cystoscopy is currently the gold standard for follow-up, but the procedure is invasive and undesirable. We aimed to investigate the feasibility of noninvasive studies for the follow-up of non-muscle invasive bladder cancer. Materials and methods This retrospective study included cases of non-muscle invasive bladder cancer diagnosed after prior transurethral resection of bladder tumor (TUR-BT) with abnormal lesion at follow-up cystoscopy, preoperative bladder MRI within 1 month, and urine cytology data available. Bladder MRI, urine cytology, and surgical pathology results were analyzed for sensitivity, specificity, positive (PPV) and negative (NPV) predictive value, accuracy, diagnostic odds ratio (DOR), and number needed to misdiagnose (NNM). Results From a total 2,258 cases of TUR-BT, 245 cases were appropriate for analysis. Combined urine cytology and bladder MRI showed a sensitivity, specificity, PPV, NPV, accuracy, DOR, and NNM of 96%, 43%, 89%, 67%, 87%, 16.2, and 7.4, respectively. Among 9 false-negative cases, 3 (1.2%) were missed by the radiologist, 2 (0.8%) had an empty bladder during MRI, and 3 (1.2%) had gross hematuria. Only 1 case (0.4%) was missed based on all signs, symptoms, and noninvasive tests. However, none of the false-negative cases showed rapid extensive progression requiring radical or partial cystectomy. Conclusions The combination of bladder MRI and urine cytology was comparable to cystoscopy for the diagnosis of recurring lesions. This may reduce the need for cystoscopy and the number of additional imaging tests for the evaluation of adjacent organs. keywords : Bladder cancer, Follow-up, Magnetic resonance imaging