Real time virtual cystoscopy (VC) of the urinary bladder is a great visualization tool that matches transurethral cystoscopy findings in many patients - and has the potential to reduce diagnostic cystoscopies in those pediatric patients who do not need biopsy or endoscopic therapy, a new study has found.

Real time virtual cystoscopy (VC) of the urinary bladder is a great visualization tool that matches transurethral cystoscopy findings in many patients - and has the potential to reduce diagnostic cystoscopies in those pediatric patients who do not need biopsy or endoscopic therapy, a new study has found.

Dr. Michael Riccabona, radiologist from the University Hospital Graz, in Austria, presented the initial experiences of his team in evaluating real time VC in infants and children at the European Congress of Radiology (ECR) 2007, on Tuesday.

Thirty patients (age between 1 and 14 years) who presented bladder pathology on conventional 2D ultrasound (US) underwent a subsequent 3DUS study including a real time VC using gradient light shaded surface rendering. The results were then evaluated for artifacts and diagnostic resolution, and compared to 2DUS, 3DUS VC and routine transurethral cystoscopy findings.

The researchers found that sufficient image quality for CV was feasible in all patients older than 3 years. In younger patients only gross pathology could be demonstrated due to resolution restrictions; in all others, 4DUS findings matched the results from transurethral cystoscopy.

Patient diagnoses included intravesical polyps, ureteroceles, ureter ostium pathology, bladder wall trabeculation and diverticula. The 4DUS-VC images and findings were slightly less detailed as the results from 3DUS-VC, but additionally allowed for functional assessment.

"The method achieved a significant change in diagnosis of the initial 2DUS report or added diagnostic value in 10 patients. 3DUS and 4DUS conspicuity was higher and presentation of the findings was more convincing using the VC display", the radiologist said.