PET/CT diagnostics of the bladder wall barrier function disorders using cystoscopic and ultrastructural 3D reconstructions (pilot study)

Aim – to evaluate the bladder wall barrier dysfunction using 11C-choline positron emission tomography/computed tomography using 3D reconstructive techniques based on visual cystoscopy and scanning electron microscopy of bladder wall tissue biopsy specimens at 6000x magnification.

Material and methods. The study was based on four clinical observations of patients with varying degrees of inflammatory changes in the bladder. In patients with bladder wall inflammation, digital PET/CT metabolic activity indices were compared with visual cystoscopic and ultrastructural 3D reconstructions.

Results. PET/CT indices of standardized 11C-choline uptake in the bladder wall correlated with 3D ultrastructural manifestations of the bladder wall barrier dysfunction across all layers, as well as with visual 3D cystoscopic changes in the mucosa during inflammation. 11C-choline PET/CT combined with advanced 3D reconstruction methods demonstrates high potential for a more accurate diagnosis and monitoring of urological diseases associated with bladder barrier dysfunction.

Conclusion. The integration of PET/CT data with cystoscopic and ultrastructural 3D reconstructions is a promising approach for a comprehensive assessment of bladder barrier function and enables the identification of underlying pathological processes at various levels. This integrated approach allows for increased diagnostic accuracy for inflammatory and destructive processes and optimizes treatment options. The introduction of such high-tech approaches into urological practice can significantly improve the quality of care for patients with inflammatory bladder pathologies.