Approximation of urinary bladder volume with few measurements on cross-sectional imaging

doi:10.4329/wjr.120003

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World Journal of Radiology

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1949-8470

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Radiol. Jun 28, 2026; 18(6): 120003
Published online Jun 28, 2026. doi: 10.4329/wjr.120003

Approximation of urinary bladder volume with few measurements on cross-sectional imaging

Robert Nelson, Celine Torkzad, Dallas Sturdevant, Pardeep K Mittal, Michael R Torkzad

Robert Nelson, Dallas Sturdevant, Department of Radiology and Imaging, Medical College of Georgia, Wellstar MCG Health, Augusta University, Augusta, GA 30912, United States

Celine Torkzad, St Johns Country Day School, Fleming Island, FL 32003, United States

Pardeep K Mittal, Michael R Torkzad, Division of Abdominal and Pelvic Radiology, Department of Radiology and Imaging, Medical College of Georgia, Wellstar MCG Health, Augusta University, Augusta, GA 30912, United States

Co-first authors: Robert Nelson and Celine Torkzad.

Author contributions: Nelson R contributed to original draft preparation, review and editing, and investigation; Torkzad C contributed to methodology; Sturdevant D contributed to writing, review, and editing of the manuscript; Mittal PK contributed to conceptualization, methodology, resources, review and editing, and supervision; Torkzad MR contributed to conceptualization, methodology, resources, review and editing, supervision, data curation, and formal analysis; all of the authors read and approved the final version of the manuscript to be published.

AI contribution statement: The authors used Microsoft Copilot solely for language editing and stylistic refinement (grammar correction, sentence clarity, and readability). The AI tool did not generate scientific content, data analyses, interpretations, or conclusions. All intellectual content and final manuscript decisions were made by the authors.

Institutional review board statement: This retrospective study was reviewed by the Institutional Review Board and determined to be exempt from Institutional Review Board approval as it involved analysis of fully anonymized imaging data and did not constitute human subjects research.

Informed consent statement: Informed consent was waived due to the retrospective nature of the study and the use of de-identified imaging data; the study was deemed non-human subjects research in accordance with institutional and regulatory guidelines.

Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.

Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request.

Corresponding author: Michael R Torkzad, MD, PhD, Division of Abdominal and Pelvic Radiology, Department of Radiology and Imaging, Medical College of Georgia, Wellstar MCG Health, Augusta University, 1120 15^th Street Augusta, Augusta, GA 30912, United States. mtorkzad@augusta.edu

Received: February 12, 2026
Revised: March 2, 2026
Accepted: May 19, 2026
Published online: June 28, 2026
Processing time: 133 Days and 11.5 Hours

Abstract

BACKGROUND

Accurate estimation of urinary bladder volume (UBV) is important for diagnosing and managing bladder disorders. Computed tomography (CT) is often used as a reference standard; however, existing measurement methods vary in complexity and efficiency.

AIM

To determine whether UBV can be accurately estimated on CT using a single sagittal measurement compared with multidimensional measurements and reference volumetric analysis.

METHODS

CT abdomen-pelvis studies of 80 individuals without urinary tract pathology were retrospectively analyzed. Bladder volume was determined using manual volumetric tracing as the reference standard. Sagittal long axis [sagittal length (SL)], sagittal short axis [sagittal short (SS)], and transverse diameter [right-to-left (RL)] were measured, and single- and multidimensional products (SL, SL × SS, SL × SS × RL) were correlated with reference volume using Pearson correlation coefficients. Linear regression models were derived, and agreement was assessed using Bland-Altman analysis.

RESULTS

SL demonstrated the strongest single-dimension correlation with bladder volume (r = 0.92), compared with SS (r = 0.87) and RL (r = 0.68). Multidimensional measurements showed slightly higher correlations (SL × SS: r = 0.98; SL × SS × RL: r = 0.99). A simplified linear formula was derived: Bladder volume (mL) = 5 × SL (mm) - 222. Bland-Altman analysis showed negligible bias and all values within the limits of agreement for the single-dimension model.

CONCLUSION

UBV can be accurately estimated using a single sagittal CT measurement in healthy individuals. This simplified approach provides a rapid and reproducible alternative to multidimensional methods without meaningful loss of accuracy and may serve as a reference standard for validating ultrasound-based bladder volume estimation.

Keywords: Urinary bladder volume; Computed tomography; Sagittal measurement; Volumetric analysis; Bladder volume estimation; Cross-sectional imaging

Core Tip: Accurate urinary bladder volume (UBV) estimation is essential for clinical decisionmaking but often requires time-consuming volumetric analysis. This study demonstrates that UBV can be reliably estimated on computed tomography using a single sagittal long-axis measurement. A simple linear formula derived from this measurement provides accuracy comparable to multidimensional methods while improving efficiency and reproducibility. This streamlined approach may standardize bladder volume assessment in routine imaging and serve as a practical reference standard for validating ultrasoundbased UBV estimation.