الفهرس 
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Abstract
Urinary bladder cancer (UBC) is one of the most common malignancies globally, with an incidence rate about 14% and a morbidity rate of 7.9% per 100,000 people, bladder cancer ranks third among all cancer types in Egypt. Bladder cancer may respond better to treatment if diagnosed early.
Most urinary bladder cancer patient’s primary risk factor is smoking different types of tobacco also there is other risk factors like occupational exposure to toxins materials (dyes, paints, metals, rubber, and petroleum-based products) and bilharzia or schistosomiasis.
Common symptom of UBC like Painless blood in the urine (hematuria), urgency, burning micturition, incontinence, frequency and flank or loin pain.
Bladder cancer can be initially diagnosed clinically, urine test, plain X-ray, intravenous urography and ultrasound negative result can be false due to low sensitivity of this tests. The gold standard technique to detect UBC is a cystoscopy; however, the disadvantages of cystoscopy include the possibility of to miss a small flat tumor, hematuria, UTI, and urethral damage from the equipment used during the procedure.
Computed tomography urography (CTU) is a widely used procedure that takes at least one series of images during a CT scan of the bladder, ureters, and kidneys. Any CTU protocol starts with the plain phase, also known as the unenhanced phase (UN), and continues with imaging in the nephrogenic phase (NP) and excretory phase (EP), after intravenous administration of a contrast agent.
CTU may miss small UBC because it is might difficult to observe especially in excretory phase (EP) due to blooming effect .This may leads to decrease the detection sensitivity and accuracy of UBC.
To increase the sensitivity of detecting of UBC a new technique called Multiphasic CTU that consist of four phases which are an unenhanced phase (UP), a corticomedullary phase (CMP), a nephrographic phase (NP), and a excretory phase (EP). Multiphasic CTU may be similar sensitive in detecting UBC as cystoscopy and more sensitive that three phases CTU.
This prospective study included 25 patients referred to radiology department, El Minia oncology institute, from March 2023 to October 2023. All patients were suspected to have UB lesion .The age of the patient ranged between 20-84 years the mean age was 63.08 ± 14.5 years and 80% of patients have hematuria, 8% have burning micturition, 8% have urgency and 4% of patients have flank pain.
Multiphasic CTU showed that 64% of tumors were detected in unenhanced phase, 96% of tumors were detected in the corticomedullary phase, 76% of tumors were detected in the nephrographic phase and 60% of tumor are detected in the secretory. Also (21/25) 84% of tumors more discrimination in the CMP according to Hounsfield unit (Hu). The Sensitivity of Multiphasic CTU were (96%) which is higher than other phases in detection of UBC.