surgoncoКреативная хирургия и онкологияCreative surgery and oncology2076-30932307-0501Башкирский государственный медицинский университет10.24060/2076-3093-2024-14-4-360-368surgonco-1022Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSМультимодальный подход к визуализации и стадированию рака мочевого пузыря: стандарты диагностики и будущие тенденцииMultimodal Approach to Imaging and Staging of Bladder Cancer: Diagnostic Standards and Future Trendshttps://orcid.org/0009-0009-3878-6989КагармановаА. Ш.KagarmanovaA. Sh.

Кагарманова Альфия Шавкатовна — лаборатория радионуклидной диагностики

Республика Башкортостан, Уфа

Alfiya Sh. Kagarmanova — Radionuclide Diagnostics Laboratory

Ufa

kagarmanovaxray@gmail.comhttps://orcid.org/0000-0002-3210-6593БайковД. Э.BaikovD. E.

Байков Денис Энверович — д.м.н., профессор, кафедра общей хирургии, трансплантологии и лучевой диагностики

Республика Башкортостан, Уфа

Denis E. Baikov — Dr. Sci. (Med.), Prof., Department of General Surgery, Transplantology and X-ray Diagnostics

Ufa

https://orcid.org/0009-0004-8621-3687ИткуловА. Ф.ItkulovA. F.

Иткулов Артур Фиргатович — специализированный консультативно-диагностический центр

Республика Башкортостан, Уфа

Artur F. Itkulov — Specialized Сounselling and Diagnostic Centre

Ufa

https://orcid.org/0000-0002-1287-814XХафизовМ. М.KhafizovM. M.

Хафизов Мунавис Мунависович — рентгеновское отделение

Республика Башкортостан, Уфа

Munavis M. Khafizov — X-ray department

Ufa

Клиника Башкирского государственного медицинского университетаРоссияClinic of Bashkir State Medical UniversityRussian FederationБашкирский государственный медицинский университет; Клиника Башкирского государственного медицинского университетаРоссияBashkir State Medical University; Clinic of Bashkir State Medical UniversityRussian Federation202428122024144360368Copyright © Кагарманова А.Ш., Байков Д.Э., Иткулов А.Ф., Хафизов М.М., 20242024Кагарманова А.Ш., Байков Д.Э., Иткулов А.Ф., Хафизов М.М.Kagarmanova A.S., Baikov D.E., Itkulov A.F., Khafizov M.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surgonco.ru/jour/article/view/1022

К наиболее важным факторам, влияющим на результативность проводимого лечения рака мочевого пузыря, относятся: подтип опухоли, степень ее клеточной анаплазии с определением уровня прорастания слоев стенки и выявлением карциномы in situ, степень нарушения функции почек, качество проводимых диагностических манипуляций, адекватная интерпретация получаемых данных, преемственность между специалистами и мотивированность к лечению самого пациента. Появление сверхвысокопольных магнитных томографов, 640-срезовых компьютерных томографов, разработка новых радиофармпрепаратов, развитие программного обеспечения в совокупности определяют мультимодальный подход к поискам оптимальных методов диагностики рака мочевого пузыря. В данном обзоре освещена роль мультипараметрической магнитнорезонансной томографии в определении степени неопластической инвазии в слои стенки мочевого пузыря, роль компьютерной томографии с внутривенным контрастным усилением в диагностике местно-распространенных форм заболевания и роль позитронно-эмиссионной томографии как перспективного метода неинвазивной характеристики физиологии опухоли с чувствительностью в пикомолярном диапазоне. Раскрыты преимущества и недостатки используемых методов визуализации в диагностике уротелиальной карциномы. Также предложены такие альтернативные методики визуализации слоев стенки мочевого пузыря, как перфузионная компьютерная томография, использование которой возможно при наличии абсолютных противопоказаний к проведению магнитно-резонансной томографии.

The most significant factors influencing the effectiveness of bladder cancer treatment include a tumor subtype, degree of cellular anaplasia, assessment of the invasion depth into the bladder wall, identification of carcinoma in situ, extent of renal function impairment, quality of diagnostic procedures, accurate interpretation of the obtained data, continuity of care among specialists, and the patient’s motivation for treatment. The advent of ultra-high-field magnetic resonance imaging, 640-slice computed tomography, development of new radiopharmaceuticals, and advancements in software technology shape a multimodal approach aimed at identifying optimal diagnostic methods for bladder cancer. The present paper reviews a potential of multiparametric magnetic resonance imaging for determining the degree of neoplastic invasion into the layers of the bladder wall, a value of computed tomography with intravenous contrast enhancement in diagnosing locally advanced forms of the disease, and capabilities of positron emission tomography as a promising method for non-invasive characterization of tumor physiology with sensitivity in the picomolar range. The paper discusses advantages and disadvantages of the imaging modalities used in the diagnosis of urothelial carcinoma. In addition, the study explores the perfusion computed tomography as an alternative imaging technology for evaluating the layers of the bladder wall to be utilized in cases of absolute contraindications to magnetic resonance imaging.

рак мочевого пузырястандарты диагностикистадирование рака мочевого пузырявизуализация рака мочевого пузырямультипараметрическая МРТперфузионная КТрадионуклидная диагностикалучевая диагностикаbladder cancerdiagnostic standardsstaging of bladder cancerimaging of bladder cancermultiparametric MRIperfusion CTradionuclide diagnosticsradiological diagnosticsReferencesFerlay J., Ervik M., Lam F., Laversanne M., Colombet M., Mery L., et al. Global Cancer Observatory: Cancer Today. Lyon: International Agency for Research on Cancer; 2024. [cited 23 Aug 2024] Available from: https://gco.iarc.who.int/todayFerlay J., Ervik M., Lam F., Laversanne M., Colombet M., Mery L., et al. Global Cancer Observatory: Cancer Today. Lyon: International Agency for Research on Cancer; 2024. [cited 23 Aug 2024] Available from: https://gco.iarc.who.int/todayКлинические рекомендации МЗ РФ. Рак мочевого пузыря. М.; 2023. 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The authors declare that there are no conflicts of interest present.