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Diagnostic performance of multidetector computed tomographic (MDCTU) in upper tract urothelial carcinoma (UTUC): a systematic review and meta-analysis. World J Urol 2019; 38:1165-1175. [DOI: 10.1007/s00345-019-02875-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/08/2019] [Indexed: 01/05/2023] Open
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Raman SP, Fishman EK. Upper and Lower Tract Urothelial Imaging Using Computed Tomography Urography. Urol Clin North Am 2018; 45:389-405. [PMID: 30031461 DOI: 10.1016/j.ucl.2018.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Computed tomography (CT) urography is the best noninvasive method of evaluating the upper urinary tract for urothelial malignancies. However, the utility of CT urography is heavily contingent on the use of proper image acquisition protocols. This article focuses on the appropriate protocols for optimizing CT urography acquisitions, including contrast administration and the timing of imaging acquisitions, as well as the use of ancillary techniques to increase collecting system distention. In addition, imaging findings are discussed that should raise concern for urothelial carcinoma at each of the 3 segments of the urinary tract: the intrarenal collecting systems, ureters, and bladder.
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Affiliation(s)
- Siva P Raman
- Department of Radiology, Johns Hopkins University, JHOC 3251, 601 North Caroline Street, Baltimore, MD 21287, USA.
| | - Elliot K Fishman
- Department of Radiology, Johns Hopkins University, JHOC 3251, 601 North Caroline Street, Baltimore, MD 21287, USA
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Upper and Lower Tract Urothelial Imaging Using Computed Tomography Urography. Radiol Clin North Am 2017; 55:225-241. [DOI: 10.1016/j.rcl.2016.10.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Colin P, Neuzillet Y, Pignot G, Rouprêt M, Comperat E, Larré S, Roy C, Quintens H, Houedé N, Soulié M, Pfister C. Surveillance des carcinomes urothéliaux : revue du Comité de cancérologie de l’Association française d’urologie. Prog Urol 2015; 25:616-24. [DOI: 10.1016/j.purol.2015.05.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 05/04/2015] [Accepted: 05/26/2015] [Indexed: 02/03/2023]
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MDCT Urography for Detecting Recurrence After Transurethral Resection of Bladder Cancer: Comparison of Nephrographic Phase With Pyelographic Phase. AJR Am J Roentgenol 2014; 203:1021-7. [DOI: 10.2214/ajr.13.12068] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Horie S, Ito S, Okada H, Kikuchi H, Narita I, Nishiyama T, Hasegawa T, Mikami H, Yamagata K, Yuno T, Muto S. Japanese guidelines of the management of hematuria 2013. Clin Exp Nephrol 2014; 18:679-89. [DOI: 10.1007/s10157-014-1001-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Battista G, Sassi C, Corcioni B, Bazzocchi A, Golfieri R, Canini R. Latest developments in imaging of bladder cancer. Expert Rev Anticancer Ther 2014; 10:881-94. [DOI: 10.1586/era.10.56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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BRIARD R, CUTHBERT F, RICHENBERG J. Haematuria. IMAGING 2013. [DOI: 10.1259/imaging.20110060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Tzeng WS, Wu RH, Huang SKH, Mak CW, Liao ACH, Lin VCH. A comparison of pyelography and various reconstructions of multidetector helical computed tomography urography images for diagnosing urinary obstruction. Clin Imaging 2012; 36:773-9. [PMID: 23154009 DOI: 10.1016/j.clinimag.2011.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 11/15/2011] [Indexed: 11/20/2022]
Abstract
Radiologists and urologists require practical and helpful image reconstructions for diagnosing urinary obstruction. We performed different types of imaging and reconstruction, then used a self-designed urinary obstruction-specific questionnaire to evaluate the diagnostic outcome of them. Our results suggested that two-dimensional (2D) axial computed tomography (CT) is clinically superior to retrograde pyelography or antegrade pyelography, and to other modes of image reconstruction that are often used for diagnosing urinary obstruction.
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Affiliation(s)
- Wen-Sheng Tzeng
- Department of Medical Imaging, Chi-Mei Medical Center, Yung Kang Campus, 901, Chung Hwa Rd, Yung Kang City, Tainan County, Taiwan.
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Clinical Significance of Bladder Urothelial Thickening and Enhancement Revealed on MDCT Urography After Transurethral Resection of Tumor. J Comput Assist Tomogr 2012; 36:243-8. [DOI: 10.1097/rct.0b013e31824afaff] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Seifert S, Mueller-Lisse U, Degenhart C, Jundt K, Mourched F, Stief C, Reiser M, Mueller-Lisse U. CT-Urographie bei Frauen mit primären oder rezidivierenden Beckentumoren. Radiologe 2011; 51:602-9. [DOI: 10.1007/s00117-011-2188-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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MDCT Enteroclysis Urography With Split-Bolus Technique Provides Information on Ureteral Involvement in Patients With Suspected Bowel Endometriosis. AJR Am J Roentgenol 2011; 196:W635-40. [DOI: 10.2214/ajr.10.4454] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Positive Predictive Value of CT Urography in the Evaluation of Upper Tract Urothelial Cancer. AJR Am J Roentgenol 2010; 195:W337-43. [DOI: 10.2214/ajr.09.4147] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Significance of Upper Urinary Tract Urothelial Thickening and Filling Defect Seen on MDCT Urography in Patients With a History of Urothelial Neoplasms. AJR Am J Roentgenol 2010; 195:959-65. [DOI: 10.2214/ajr.09.4177] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Wang LJ, Wong YC, Ng KF, Chuang CK, Lee SY, Wan YL. Tumor Characteristics of Urothelial Carcinoma on Multidetector Computerized Tomography Urography. J Urol 2010; 183:2154-60. [PMID: 20399464 DOI: 10.1016/j.juro.2010.02.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 10/27/2009] [Indexed: 10/19/2022]
Affiliation(s)
- Li-Jen Wang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Yon-Cheong Wong
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Kwai-Fong Ng
- Department of Pathology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Cheng-Keng Chuang
- Department of Urology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Shen-Yang Lee
- Department of Nephrology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Yung-Liang Wan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
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Wang LJ, Wong YC, Huang CC, Wu CH, Hung SC, Chen HW. Multidetector computerized tomography urography is more accurate than excretory urography for diagnosing transitional cell carcinoma of the upper urinary tract in adults with hematuria. J Urol 2010; 183:48-55. [PMID: 19913253 DOI: 10.1016/j.juro.2009.08.144] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2009] [Indexed: 11/24/2022]
Abstract
PURPOSE It is debatable whether traditionally used excretory urography or the recently introduced multidetector computerized tomography urography is more accurate for diagnosing upper urinary tract transitional cell carcinoma. We compared accuracy measures of both methods for diagnosing upper urinary tract transitional cell carcinoma in adult patients with hematuria. MATERIALS AND METHODS We retrospectively analyzed consecutive adult patients with hematuria undergoing excretory urography and multidetector computerized tomography urography before any surgery, intervention or treatment from April 2004 to December 2006 in our hospital. The presence of upper urinary tract transitional cell carcinoma on excretory urography and multidetector computerized tomography urography was reviewed independently by 2 uroradiologists who were blinded to clinical information and other imaging results. Final diagnosis of upper urinary tract transitional cell carcinoma was confirmed by histological results. Measures of the diagnostic accuracy of excretory urography and multidetector computerized tomography urography for upper urinary tract transitional cell carcinoma were calculated and compared with reference to the final diagnosis. RESULTS Of 34 men and 26 women with hematuria (mean age 60.73 +/- 12.95 years) 19 (31.7%) had a final diagnosis of 24 upper urinary tract transitional cell carcinomas. The sensitivity, specificity and accuracy of excretory urography were 0.750, 0.860 and 0.849, respectively. In contrast, the sensitivity, specificity and accuracy of multidetector computerized tomography urography were 0.958, 1.000 and 0.996, respectively. Overall the area under the receiver operating characteristic curve for multidetector computerized tomography urography was significantly larger than that for excretory urography (0.978 vs 0.815, p = 0.005). CONCLUSIONS Multidetector computerized tomography urography is more sensitive, specific and accurate than excretory urography in the diagnosis of upper urinary tract transitional cell carcinoma in adult patients with hematuria. Therefore, multidetector computerized tomography urography rather than excretory urography should be the first choice noninvasive imaging modality for diagnosing upper urinary tract transitional cell carcinoma.
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Affiliation(s)
- Li-Jen Wang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Affiliation(s)
- Anne M Silas
- Department of Radiology, Interventional Radiology and Abdominal Imaging, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
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Abstract
OBJECTIVE The purpose of this article is to review the epidemiology, staging, and treatment of bladder cancer; to discuss the role of MDCT urography for the evaluation of patients with known or suspected bladder cancer; and to address the role of MDCT urography in patients who require follow-up imaging after a diagnosis of bladder cancer has been made. CONCLUSION MDCT urography now has a large role in the evaluation of patients with known and suspected bladder cancer. However, its precise role has not been established. Because many bladder neoplasms will not be detected by MDCT urography and more research is needed to determine the optimal technique for diagnosing bladder cancer, we think that MDCT urography cannot replace cystoscopy at present.
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Diagnostic Accuracy of Transitional Cell Carcinoma on Multidetector Computerized Tomography Urography in Patients With Gross Hematuria. J Urol 2009; 181:524-31; discussion 531. [PMID: 19100576 DOI: 10.1016/j.juro.2008.10.024] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2008] [Indexed: 11/21/2022]
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Transitional Cell Neoplasm of the Upper Urinary Tract: Evaluation with MDCT. AJR Am J Roentgenol 2008; 191:416-22. [DOI: 10.2214/ajr.07.3649] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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