{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T19:22:14Z","timestamp":1788808934828,"version":"build-2803163510"},"reference-count":44,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Despite the high incidence of bladder cancer (it represents the 7th most common cancer in males), EAU guidelines do not recommend any technique for screening and prevention, whereas the main diagnostic tools remain computed tomography urography (CTU), cytology, and cystoscopy. Unfortunately, these gold-standard modalities are mainly characterized by low sensitivity and accuracy. To minimize the limitations and increase the detection rates of urothelial cancer, several technologies have been developed. In our review, we summarize all the available data concerning the contemporary technological novelties that include imaging, cytology, and endoscopic techniques in pursuit of finding the optimal combination of diagnostic tools that can provide better detection accuracy.<\/jats:p>","DOI":"10.3390\/medicina61010071","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T11:50:10Z","timestamp":1735905010000},"page":"71","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["New Trends and Future Perspectives in the Diagnosis of Urothelial Carcinoma: A Comprehensive Review of the Literature"],"prefix":"10.3390","volume":"61","author":[{"given":"Mourmouris","family":"Panagiotis","sequence":"first","affiliation":[{"name":"Urology Department, Metropolitan Hospital, Neo Faliro, 18547 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgopoulos","family":"Ioannis","sequence":"additional","affiliation":[{"name":"Urology Department, Metropolitan Hospital, Neo Faliro, 18547 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klapsis","family":"Vasilleios","sequence":"additional","affiliation":[{"name":"Urology Department, Metropolitan Hospital, Neo Faliro, 18547 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pisiotis","family":"Nikolaos","sequence":"additional","affiliation":[{"name":"Urology Department, Metropolitan Hospital, Neo Faliro, 18547 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salmas","family":"Ioannis","sequence":"additional","affiliation":[{"name":"Urology Department, Metropolitan Hospital, Neo Faliro, 18547 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charamoglis","family":"Sotirios","sequence":"additional","affiliation":[{"name":"Urology Department, Metropolitan Hospital, Neo Faliro, 18547 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,3]]},"reference":[{"key":"ref_1","unstructured":"International Agency for Research on Cancer WHO (2020, December 03). Estimated Number of New Cases In 2020, Worldwide, Both Sexes, All Ages 2021. Available online: https:\/\/gco.iarc.fr\/today\/online-analysis-table?v=2020&mode=cancer&mode_population=continents."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/s00345-016-1928-x","article-title":"Epidemiology, diagnosis, preoperative evaluation and prognostic assessment of upper-tract urothelial carcinoma (UTUC)","volume":"35","author":"Soria","year":"2017","journal-title":"World J. Urol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1007\/s10552-021-01416-2","article-title":"Incidence rates and contemporary trends in primary urethral cancer","volume":"32","author":"Wenzel","year":"2021","journal-title":"Cancer Causes Control."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.eururo.2021.08.010","article-title":"European Association of Urology Guidelines on Non-muscle-invasive Bladder Cancer (Ta, T1, and Carcinoma in Situ)","volume":"81","author":"Babjuk","year":"2022","journal-title":"Eur. Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1038\/nrurol.2016.252","article-title":"Diagnostic dilemmas in patients with upper tract urothelial carcinoma","volume":"4","author":"Baard","year":"2017","journal-title":"Nat. Rev. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1615\/JEnvironPatholToxicolOncol.v26.i2.90","article-title":"Improving the management of bladder cancer with fluorescence cystoscopy","volume":"26","author":"Grossman","year":"2007","journal-title":"J. Environ. Pathol. Toxicol. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3786","DOI":"10.1007\/s00261-019-02111-2","article-title":"CT urography: How to optimize the technique","volume":"44","author":"Cheng","year":"2019","journal-title":"Abdom. Radiol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Gershan, V., Homayounieh, F., Singh, R., Avramova-Cholakova, S., Faj, D., Georgiev, E., Girjoaba, O., Griciene, B., Gruppetta, E., and \u0160imonji, D.H. (2020). CT protocols and radiation doses for hematuria and urinary stones: Comparing practices in 20 countries. Eur. J. Radiol., 126.","DOI":"10.1016\/j.ejrad.2020.108923"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"641","DOI":"10.2214\/AJR.17.19370","article-title":"Comparison of full- and half-dose image reconstruction with filtered back projection or sinogram-affirmed iterative reconstruction in dual-source single-energy MDCT Urography","volume":"211","author":"Kim","year":"2018","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"347","DOI":"10.2214\/AJR.13.12021","article-title":"Bladder malignancies on CT: The underrated role of CT in diagnosis","volume":"203","author":"Raman","year":"2014","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1007\/s11547-021-01341-z","article-title":"Dual-energy CT quantification of fractional extracellular space in cirrhotic patients: Comparison between early and delayed equilibrium phases and correlation with oesophageal varices","volume":"126","author":"Cicero","year":"2021","journal-title":"Radiol. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1002\/mp.13326","article-title":"Deep-learning convolutional neural network: Inner and outer bladder wall segmentation in CT urography","volume":"46","author":"Gordon","year":"2019","journal-title":"Med. Phys."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5814","DOI":"10.1002\/mp.12510","article-title":"Urinary bladder cancer staging in CT urography using machine learning","volume":"44","author":"Garapati","year":"2017","journal-title":"Med Phys."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2103","DOI":"10.1007\/s00330-019-06530-z","article-title":"Imaging protocols for renal multiparametric MRI and MR urography: Results of a consensus conference from the French Society of Genitourinary Imaging","volume":"30","author":"Cornelis","year":"2020","journal-title":"Eur. Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.eururo.2018.04.029","article-title":"Multiparametric magnetic resonance imaging for bladder cancer: Development of VI-RADS (vesical imaging-reporting and data system)","volume":"74","author":"Panebianco","year":"2018","journal-title":"Eur. Urol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1111\/1754-9485.13317","article-title":"Accuracy of the vesical imaging-reporting and data system (VIRADS) for pre-treatment staging of bladder cancer in an Australian cohort","volume":"66","author":"Huang","year":"2022","journal-title":"J. Med. Imaging Radiat. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.ajur.2021.06.001","article-title":"Validation of vesical imaging reporting and data system score for the diagnosis of muscle-invasive bladder cancer: A prospective cross-sectional study","volume":"9","author":"Ghanshyam","year":"2022","journal-title":"Asian J. Urol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1007\/s00345-022-03969-6","article-title":"The accuracy of vesical imaging-reporting and data system (VI-RADS): An updated comprehensive multi-institutional, multi-readers systematic review and meta-analysis from diagnostic evidence into future clinical recommendations","volume":"40","author":"Flammia","year":"2022","journal-title":"World J. Urol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1309\/AJCPPRZLG9KT9AXL","article-title":"Accuracy of urine cytology and the significance of an atypical category","volume":"132","author":"Brimo","year":"2009","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1002\/cncy.20099","article-title":"Fluorescence in situ hybridization for detecting urothelial carcinoma: A clinicopathologic study","volume":"118","author":"Caraway","year":"2010","journal-title":"Cancer Cytopathol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1002\/cncy.20168","article-title":"A multicolor fluorescence in situ hybridization assay: A monitoring tool in the surveillance of patients with a history of non-muscle-invasive urothelial cell carcinoma: A prospective study","volume":"119","author":"Salido","year":"2011","journal-title":"Cancer Cytopathol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"296.e1","DOI":"10.1016\/j.urolonc.2022.12.012","article-title":"Performance of CellDetect for detection of bladder cancer: Comparison with urine cytology and UroVysion","volume":"41","author":"Shefer","year":"2023","journal-title":"Urol. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1007\/s10147-022-02216-7","article-title":"Diagnostic performance of fluorescence in situ hybridization (FISH) in upper tract urothelial carcinoma (UTUC): A systematic review and meta-analysis","volume":"27","author":"Aalami","year":"2022","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1002\/cncy.22615","article-title":"Evaluation of an artificial intelligence algorithm for assisting the Paris System in reporting urinary cytology: A pilot study","volume":"130","author":"Ou","year":"2022","journal-title":"Cancer Cytopathol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1111\/j.1365-2303.2006.00432.x","article-title":"Expression of cytokeratin 20 in urine cytology smears: A potential marker for the detection of urothelial carcinoma","volume":"18","author":"Bhatia","year":"2007","journal-title":"Cytopathology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"242","DOI":"10.14712\/fb2011057060242","article-title":"Urinary BLCA-4 is highly specific for detection of bladder cancer in Chinese Han population and is related to tumour invasiveness","volume":"57","author":"Feng","year":"2011","journal-title":"Folia Biol"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/j.eururo.2006.12.019","article-title":"Urinary CYFRA 21.1 is not a useful marker for the detection of recurrences in the follow-up of superficial bladder cancer","volume":"51","author":"Barmadah","year":"2007","journal-title":"Eur. Urol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"13539","DOI":"10.18632\/oncotarget.3841","article-title":"Highly sensitive and specific novel biomarkers for the diagnosis of transitional bladder carcinoma","volume":"6","author":"Kumar","year":"2015","journal-title":"Oncotarget"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"43432","DOI":"10.18632\/oncotarget.9468","article-title":"Urine gamma-synuclein as a biomarker for the diagnosis of bladder cancer","volume":"7","author":"Liu","year":"2016","journal-title":"Oncotarget"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s00432-004-0561-z","article-title":"The expression and significance of survivin mRNA in urinary bladder carcinomas","volume":"130","author":"Wang","year":"2004","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"100648","DOI":"10.18632\/oncotarget.22065","article-title":"Evaluation of the NMP22 BladderChek test for detecting bladder cancer: A systematic review and meta-analysis","volume":"8","author":"Wang","year":"2017","journal-title":"Oncotarget"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1097\/01.ju.0000067461.30468.6d","article-title":"Tumor markers in the diagnosis of primary bladder cancer. A systematic review","volume":"169","author":"Glas","year":"2003","journal-title":"J. Urol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1016\/j.euf.2022.02.006","article-title":"Reducing the Frequency of Follow-up Cystoscopy in Low-grade pTa Non-muscle-invasive Bladder Cancer Using the ADXBLADDER Biomarker","volume":"8","author":"Gontero","year":"2022","journal-title":"Eur. Urol. Focus."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.ejca.2015.11.003","article-title":"Gene expression test for the non-invasive diagnosis of bladder cancer: A prospective, blinded, international and multicenter validation study","volume":"54","author":"Ribal","year":"2016","journal-title":"Eur. J. Cancer"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/S0090-4295(94)80203-3","article-title":"Intravesical instillation of 5-aminolevulinic acid: The fluorescent metabolite is limited to urothelial cells","volume":"44","author":"Steinbach","year":"1994","journal-title":"Urology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"361.e1","DOI":"10.1016\/j.urolonc.2018.04.013","article-title":"Blue light cystoscopy for the diagnosis of bladder cancer: Results from the US prospective multicenter registry","volume":"36","author":"Daneshmand","year":"2018","journal-title":"Urol. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1016\/j.juro.2017.11.096","article-title":"Efficacy and safety of blue light flexible cystoscopy with hexaminolevulinate in the surveillance of bladder cancer: A phase iii, comparative, multicenter study","volume":"199","author":"Daneshmand","year":"2018","journal-title":"J. Urol."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Xiong, Y., Li, J., Ma, S., Ge, J., Zhou, L., Li, D., and Chen, Q. (2017). A meta-analysis of narrow band imaging for the diagnosis and therapeutic outcome of non-muscle invasive bladder cancer. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0170819"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Lai, L.Y., Tafuri, S.M., Ginier, E.C., Herrel, L.A., Dahm, P., Maisch, P., and Lane, G.I. (2022). Narrow band imaging versus white light cystoscopy alone for transurethral resection of non-muscle invasive bladder cancer. Cochrane Database Syst. Rev., 4.","DOI":"10.1002\/14651858.CD014887.pub2"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.urology.2016.11.032","article-title":"Comparison of white light, photodynamic diagnosis, and narrow-band imaging in detection of carcinoma in situ or flat dysplasia at transurethral resection of the bladder: The DaBlaCa-8 study","volume":"102","author":"Drejer","year":"2017","journal-title":"Urology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"98","DOI":"10.4111\/icu.2018.59.2.98","article-title":"Detection and recurrence rate of transurethral resection of bladder tumors by narrow-band imaging: Prospective, randomized comparison with white light cystoscopy","volume":"59","author":"Kim","year":"2018","journal-title":"Investig. Clin. Urol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1089\/end.2015.0687","article-title":"Comparing image perception of bladder tumors in four different storz professional image enhancement system modalities using the \u00edSPIES","volume":"30","author":"Kamphuis","year":"2016","journal-title":"App. J. Endourol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1089\/end.2005.19.570","article-title":"Evaluation of superficial bladder transitional-cell carcinoma by optical coherence tomography","volume":"19","author":"Manyak","year":"2005","journal-title":"J. Endourol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1089\/end.2015.0523","article-title":"A pilot study of in vivo confocal laser endomicroscopy of upper tract urothelial carcinoma","volume":"29","author":"Bui","year":"2015","journal-title":"J. Endourol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/1\/71\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:22:40Z","timestamp":1759918960000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/1\/71"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,3]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["medicina61010071"],"URL":"https:\/\/doi.org\/10.3390\/medicina61010071","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,3]]}}}