[Prostatic and bladder cancer--desiderata of the urologist as regards diagnostic imaging].

Abstract

On the background of a continuous increase of knowledge in urologic oncology, the need for actual information and for interdisciplinary cooperation we discuss the diagnostics of prostatic and cystic carcinoma from the standpoint of the required therapy. The threshold of diagnostic detectability of prostatic carcinoma today is approximately the size of a matches head. By transrectal sonography and MRT the anatomic zones of the prostate are imaged and a selective biopsy becomes possible. Morphometric studies of prostatic carcinoma with pathologic-anatomical descriptions of the tumour volume and capsular penetration are described. The requirements for medical imaging for sufficient information on tumour volume, seminal bladder infiltration, capsular infiltration and lymph node diagnostics are derived. For the diagnostics of bladder carcinoma the significance of the lamina propria as a separating membrane between superficial and infiltrating carcinoma is discussed. Possibilities and limitations for the T- and N-determination of infiltrating carcinoma with CT and MRT and new therapy concepts (neoadjuvant chemotherapy) for the muscle-infiltrating cystic carcinoma are discussed.