ArticleAbdominal radiology (New York)2026
Clinical indicators combined with spectral CT in differentiating non-muscle-invasive bladder urothelial carcinoma from cystitis glandularis.
Article in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo investigate the diagnostic value of various indicators and models for the differential diagnosis of non-muscle-invasive bladder urothelial carcinoma (NIBUC) and cystitis glandularis (CG).
methodsA retrospective analysis was performed using clinical and spectral computed tomography (CT) data from consecutive patients at Lanzhou University Second Hospital between January 2022 and January 2024. All patients underwent unenhanced arterial- and venous-phase spectral CT. Regions of interest were manually placed on the largest cross-section of the lesion. Iodine concentration (IC) and 40-70 keV monoenergetic CT values were measured in arterial and venous phases. The slope of the spectral CT-mono-energetic curve (40 and 70 keV; λHU) was calculated. Logistic regression analysis was used to construct two predictive models: one combining significant clinical indicators + conventional CT, and the other combining clinical indicators + conventional CT. +spectral CT parameters. The diagnostic performance was evaluated using receiver operating characteristic curve analysis.
resultsThirty-nine patients with NIBUC and 21 patients with CG, all pathologically confirmed by surgery, were included. Differences in age, lower urinary tract symptoms, and maximum lesion diameter were significant between the two groups (all P < 0.05). The IC and the slope of the spectral CT monoenergetic curve in the arterial and venous phases were significantly higher in the NIBUC group than in the CG group (all P < 0.05). The arterial-phase spectral curve slope showed good diagnostic performance among the arterial- and venous-phase IC and spectral curve slopes (area under the curve [AUC] = 0.879). The combined model CI-CCT-λHU, incorporating statistically significant clinical indicators, conventional CT parameters, and arterial phase spectral curve slope, achieved the best diagnostic accuracy (AUC = 0.919).
conclusionThe arterial phase spectral curve slope provided good diagnostic efficacy for differentiating NIBUC from CG. A CI-CCT-λHU model combining clinical indicators, conventional CT, and arterial phase spectral curve slope can further improve the accuracy of differential diagnosis for these two lesions.
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