Editing Bladder Cancer: Diagnosis and Evaluation (section)

==== Timing ====

* Optimal timing not clear, should likely be risk stratified and generally within 6 months of initial diagnosis.

* '''Usually performed before transurethral resection'''
**If imaging is obtained after transurethral resection, it should be delayed ≈7 days post-procedure to minimize inflammatory artifact, which can be mistaken for T3 disease

===== Modality =====
*'''Contrast-based axial imaging, such as CT or MRI are recommended.'''
** The sensitivity and specificity of CT in detecting nodal metastasis ranges from 31-50% and 68%-100%, respectively
** MRI is generally considered to be more accurate than CT in detecting local tumor stage; however, reports vary in the literature
** Retrograde pyelogram and intravenous urography may also be used when CT or MRI are unavailable.
** US alone may not provide sufficient anatomic detail for upper urinary tract imaging during the work-up of bladder cancer

===== Findings =====
* '''Hydronephrosis on cross-sectional imaging is suspicious for muscle invasion/extravesical disease'''