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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Urology 1/2015

The potential utility of non-invasive imaging to monitor restoration of bladder structure and function following subtotal cystectomy (STC)

Zeitschrift:
BMC Urology > Ausgabe 1/2015
Autoren:
David Burmeister, Bimjhana Bishwokarma, Tamer AbouShwareb, John Olson, Maja Herco, Josh Tan, Karl-Erik Andersson, George Christ
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

DB organized the study design, performed statistical analysis and drafted the manuscript. BB participated in cystometric and histological studies. TA participated in design of the study and animal surgeries. JO performed all MRI procedure troubleshooting. MH analyzed all MRI images and participated in cystometric studies. JT helped design and interpret CT and MRI studies. KEA was involved in conception, design, coordination of the study and helped draft the manuscript. GJC was involved in conception, design, coordination of the study and helped draft the manuscript. All authors have read and approved the final manuscript.

Abstract

Background

Restoration of normal bladder volume and function (i.e., bioequivalent bladder) are observed within 8 weeks of performing subtotal cystectomy (STC; removal of ~70 % of the bladder) in 12-week old rats. For analysis of bladder function in rodents, terminal urodynamic approaches are largely utilized. In the current study, we investigated the potential for Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans to noninvasively track restoration of structure and function following STC.

Methods

Twelve week old female Fisher F344 rats underwent STC and were scanned via CT and/or MRI 2, 4, 8, and 12 weeks post-STC, followed by urodynamic testing. After euthanasia, bladders were excised for histological processing.

Results

MRI scans demonstrated an initial decline followed by a time-dependent increase to normal bladder wall thickness (BWT) by 8 weeks post-STC. Masson’s trichrome staining showed a lack of fibrosis post-STC, and also revealed that the percent of smooth muscle in the bladder wall at 2 and 4 weeks positively correlated with pre-operative baseline BWT. Moreover, increased BWT values before STC was predictive of improved bladder compliance at 2 and 4 weeks post-STC. Cystometric studies indicated that repeated MRI manipulation (i.e. bladder emptying) apparently had a negative impact on bladder capacity and compliance. A “window” of bladder volumes was identified 2 weeks post-STC via CT scanning that were commensurate with normal micturition pressures measured in the same animal 6 weeks later.

Conclusions

Taken together, the data indicate some limitations of “non-invasive” imaging to provide insight into bladder regeneration. Specifically, mechanical manipulation of the bladder during MRI appears to negatively impact the regenerative process per se, which highlights the importance of terminal cystometric studies.
Literatur
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