1
|
Yao C, Liu X, Lu X, Wang L, Jia J, Li Z. Smartphone-Based Fluorescent Profiling of Quaternary MicroRNAs in Urine for Rapid Diagnosis of Urological Cancers Using a Multiplexed Isothermal Exponential Amplification Reaction. Anal Chem 2024; 96:419-426. [PMID: 38152877 DOI: 10.1021/acs.analchem.3c04461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Urological cancers such as bladder or prostate cancer represent one of the most malignant tumors that accounts for an extremely high mortality. However, conventionally standard diagnostics for urological cancers are hardly available in low-resource settings. We developed herein a hand-held fluorescent imaging platform by integrating a multiplexed isothermal exponential amplification reaction (EXPAR) with a microgel-enriched methodology for sensitive profiling of quaternary microRNAs (miRNAs) in urine and quick diagnosis of urological cancers at the early stage. The target miRNA mixtures in the urine underwent four parallel EXPARs without cross-reactivity, followed by surface concentration and hybridization by the encoded polyacrylamide microgels. This mix-and-read strategy allowed for one-pot analysis of several key miRNAs simultaneously and provided 5-fold enhancement in fluorescent detection sensitivities compared to the individual EXPAR-based assays. Four urinary miRNAs (let-7a, miRNA-155, -223, and -143) could be quantitatively determined in a wide linear range from 50 fM to 30 nM, with the limits of detection at femtomolar levels. Using a smartphone-based imaging microreader, healthy and cancerous cohorts with prostate, bladder, and renal cell cancers could be discriminated in 30 min with the accuracy >83% using linear discriminant analysis. The developed detection platform has proven to be a portable, noninvasive, and useful complement to the toolbox for miRNA-based liquid biopsies, which holds immense potential and advantage for regular and large-scale applications in early cancer diagnosis.
Collapse
Affiliation(s)
- Chanyu Yao
- Institute for Advanced Study, Shenzhen University, 3688 Nanhai Road, Shenzhen, Guangdong 518060, P. R. China
| | - Xueliang Liu
- School of Basic Medical Sciences, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, Henan 453003, P. R. China
| | - Xiaohui Lu
- Institute for Advanced Study, Shenzhen University, 3688 Nanhai Road, Shenzhen, Guangdong 518060, P. R. China
| | - Lei Wang
- Department of Urology, Xinxiang Central Hospital, Xinxiang Medical College, 56 Jinsui Road, Xinxiang, Henan 453003, P. R. China
| | - Jia Jia
- Department of Anesthesiology and Perioperative Medicine, Zhengzhou University People's Hospital, Zhengzhou, Henan 450003, P. R. China
| | - Zheng Li
- Institute for Advanced Study, Shenzhen University, 3688 Nanhai Road, Shenzhen, Guangdong 518060, P. R. China
| |
Collapse
|
2
|
Bae SB, Yoon SK, Rha SH. Urothelial Carcinoma of the Renal Pelvis with Synchronous Ipsilateral Collecting Duct Carcinoma: Two Case Reports. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2024; 85:222-229. [PMID: 38362392 PMCID: PMC10864140 DOI: 10.3348/jksr.2023.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/15/2023] [Accepted: 10/04/2023] [Indexed: 02/17/2024]
Abstract
Synchronous renal malignancies are seldom encountered or diagnosed post-renal resection. A combination of renal cell carcinoma (RCC) and urothelial carcinoma (UC) is most commonly reported. Typically, the RCC subtype is clear-cell RCC; however, a combination of collecting duct carcinoma (CDC) and UC has rarely been reported in the existing literature. Here, we present two cases of synchronous renal malignancy, specifically a combination of CDC and UC, in the ipsilateral kidney.
Collapse
|
3
|
Coppola A, Gatta T, Pini GM, Scordi G, Fontana F, Piacentino F, Minici R, Laganà D, Basile A, Dehò F, Carcano G, Franzi F, Uccella S, Sessa F, Venturini M. Neuroendocrine Carcinoma of the Urinary Bladder: CT Findings and Radiomics Signature. J Clin Med 2023; 12:6510. [PMID: 37892647 PMCID: PMC10607129 DOI: 10.3390/jcm12206510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/07/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
Background: We present a case series of Neuroendocrine Carcinoma of the Urinary Bladder (NECB) to analyse their radiologic appearance on CT, find a "Radiomic signature", and review the current literature. Methods: 14 CT cases of NECB were reviewed and compared with a control group of 42 patients with high-grade non-neuroendocrine bladder neoplasm for the following parameters: ring enhancement; implantation site; dimensions; density; margins; central necrosis; calcifications; number of lesions; wall thickness; depth of invasion in the soft tissue; invasion of fat tissue; invasion of adjacent organs; lymph-node involvement; abdominal organ metastasis. To extract radiomic features, volumes of interest of bladder lesions were manually delineated on the portal-venous phase. The radiomic features of the two groups were identified and compared. Results: Statistical differences among NECB and control group were found in the prevalence of male sex (100% vs. 69.0%), hydronephrosis (71.4% vs. 33.3%), mean density of the mass (51.01 ± 15.48 vs. 76.27 ± 22.26 HU); product of the maximum diameters on the axial plane (38.1 ± 59.3 vs. 14.44 ± 12.98 cm2) in the control group, trigonal region involvement (78.57% vs. 19.05%). About the radiomic features, Student's t-test showed significant correlation for the variables: "DependenceNonUniformity" (p: 0.048), "JointAverage" (p: 0.013), "LargeAreaLowGrayLevelEmphasis" (p: 0.014), "Maximum2DDiameterColumn" (p: 0.04), "Maximum 2DDiameterSlice" (p: 0.007), "MeanAbsoluteDeviation" (p: 0.021), "BoundingBoxA" (p: 0.022) and "CenterOfMassB" (p: 0.007). Conclusions: There is a typical pattern (male patient, large mass, trigonal area involvement) of NECB presentation on contrast-enhanced CT. Certain morphological characteristics and encouraging results about Radiomic features can help define the diagnosis.
Collapse
Affiliation(s)
- Andrea Coppola
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (T.G.); (F.F.); (F.P.); (M.V.)
- Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy; (F.D.); (G.C.); (F.F.); (F.S.)
| | - Tonia Gatta
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (T.G.); (F.F.); (F.P.); (M.V.)
- Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy; (F.D.); (G.C.); (F.F.); (F.S.)
| | - Giacomo Maria Pini
- Department of Pathology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Giorgia Scordi
- Postgraduate School of Radiology Technician, Insubria University, 21100 Varese, Italy;
| | - Federico Fontana
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (T.G.); (F.F.); (F.P.); (M.V.)
- Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy; (F.D.); (G.C.); (F.F.); (F.S.)
| | - Filippo Piacentino
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (T.G.); (F.F.); (F.P.); (M.V.)
- Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy; (F.D.); (G.C.); (F.F.); (F.S.)
| | - Roberto Minici
- Radiology Unit, Department of Experimental and Clinical Medicine, University Hospital Mater Domini, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (R.M.); (D.L.)
| | - Domenico Laganà
- Radiology Unit, Department of Experimental and Clinical Medicine, University Hospital Mater Domini, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (R.M.); (D.L.)
| | - Antonio Basile
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies, University Hospital “Policlinico-Vittorio Emanuele”, 95123 Catania, Italy;
| | - Federico Dehò
- Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy; (F.D.); (G.C.); (F.F.); (F.S.)
- Urology Unit, CircoloHospital, ASST Sette Laghi, 21100 Varese, Italy
| | - Giulio Carcano
- Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy; (F.D.); (G.C.); (F.F.); (F.S.)
- General, Emergency and Transplant Surgery Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy
| | - Francesca Franzi
- Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy; (F.D.); (G.C.); (F.F.); (F.S.)
- Patology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy
| | - Silvia Uccella
- Pathology Unit, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Italy;
| | - Fausto Sessa
- Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy; (F.D.); (G.C.); (F.F.); (F.S.)
- Patology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy
| | - Massimo Venturini
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (T.G.); (F.F.); (F.P.); (M.V.)
- Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy; (F.D.); (G.C.); (F.F.); (F.S.)
| |
Collapse
|
4
|
Bhatia H, Sinha A, Mishra A. Acute Epigastric Pain: Unexpected Urologic Findings on Computed Tomography. Urology 2023; 176:e10-e12. [PMID: 37030578 DOI: 10.1016/j.urology.2023.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 02/19/2023] [Accepted: 03/27/2023] [Indexed: 04/09/2023]
Abstract
Mesenteric panniculitis is a relatively common condition encountered on cross-sectional imaging and is mostly asymptomatic. We present one such case where an underlying malignancy was brought to forefront due to associated mesenteric panniculitis presenting as acute abdomen.
Collapse
Affiliation(s)
- Harsimran Bhatia
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anindita Sinha
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Anand Mishra
- Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
5
|
The Role of CT Imaging in Characterization of Small Renal Masses. Diagnostics (Basel) 2023; 13:diagnostics13030334. [PMID: 36766439 PMCID: PMC9914376 DOI: 10.3390/diagnostics13030334] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/02/2023] [Accepted: 01/09/2023] [Indexed: 01/18/2023] Open
Abstract
Small renal masses (SRM) are increasingly detected incidentally during imaging. They vary widely in histology and aggressiveness, and include benign renal tumors and renal cell carcinomas that can be either indolent or aggressive. Imaging plays a key role in the characterization of these small renal masses. While a confident diagnosis can be made in many cases, some renal masses are indeterminate at imaging and can present as diagnostic dilemmas for both the radiologists and the referring clinicians. This review focuses on CT characterization of small renal masses, perhaps helping us understand small renal masses. The following aspects were considered for the review: (a) assessing the presence of fat, (b) assessing the enhancement, (c) differentiating renal tumor subtype, and (d) identifying valuable CT signs.
Collapse
|
6
|
Sanyal SR, Arora A, Nisreen A, Mohamed K, Mohammad SK, Baruah D. Imaging Tips and Tricks in Management of Renal and Urothelial Malignancies. Indian J Radiol Imaging 2022; 32:213-223. [PMID: 35924135 PMCID: PMC9340167 DOI: 10.1055/s-0042-1744520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
AbstractManagement of urological malignancies has evolved significantly with continually changing guidelines and treatment options which demand more centralized involvement of radiology than ever before.Radiologists play a pivotal role in interpreting complex cancer scans and guiding clinical teams toward the best management options in the light of clinical profile. Management of complex uro-oncology cases is often discussed in multidisciplinary meetings which are essential checkpoints to evaluate an overall picture and formulate optimal treatment plans.The aim of this article is to provide a radiological perspective with practical guidance to fellow radiologists participating in uro-oncology multidisciplinary meetings based on commonly encountered case scenarios, updated guidelines, and cancer pathways.Crucial imaging tips with regards to renal and urinary tract cancers, upon which therapeutic decisions are made, have been condensed in this article after reviewing several complex cases from urology multidisciplinary meetings and European Association of Urology guidelines.Outline of various diagnostic and management strategies, key staging features, surveillance guidelines, and, above all, what the onco-urologists want to know from radiologists have been succinctly discussed in this article.
Collapse
Affiliation(s)
| | - Ankur Arora
- Department of Radiology, Royal Liverpool and Broadgreen University Hospitals NHS Trusst, Liverpool, United Kingdom
| | - Amin Nisreen
- Department of Radiology, Royal Preston Hospital, Preston, United Kingdom
| | - Khattab Mohamed
- Department of Radiology, Royal Preston Hospital, Preston, United Kingdom
| | | | - Deb Baruah
- Department of Radiology, Tezpur Medical College, Assam, India
| |
Collapse
|
7
|
Madaan PK, Ghasi RG. Conventional uroradiology with excretory urography: a forgotten art? Br J Radiol 2022; 95:20210949. [PMID: 34990261 PMCID: PMC9153722 DOI: 10.1259/bjr.20210949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Excretory urography (EU) had been the most frequently performed imaging modality for uroradiology in the past. With the advances in ultrasonography, and development of cross-sectional urography with CT and MRI, EU is now seldom performed. Consequently, there has been a decline of expertise in this technique. However, EU has multiple advantages such as dynamic nature, easy availability, low cost and radiation burden. These render it potentially very valuable in specific indications like congenital anomalies, urothelial lesions and urinary leaks. This review intends to emphasize the current day relevance of excretory urography, outline the key points of the technique, and describe the pearls and pitfalls of interpretation.
Collapse
Affiliation(s)
| | - Rohini Gupta Ghasi
- Department of Radiodiagnosis, VMMC and Safdarjung Hospital, New Delhi, India
| |
Collapse
|
8
|
Lyske J, Mathew RP, Hutchinson C, Patel V, Low G. Multimodality imaging review of focal renal lesions. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-020-00391-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Focal lesions of the kidney comprise a spectrum of entities that can be broadly classified as malignant tumors, benign tumors, and non-neoplastic lesions. Malignant tumors include renal cell carcinoma subtypes, urothelial carcinoma, lymphoma, post-transplant lymphoproliferative disease, metastases to the kidney, and rare malignant lesions. Benign tumors include angiomyolipoma (fat-rich and fat-poor) and oncocytoma. Non-neoplastic lesions include infective, inflammatory, and vascular entities. Anatomical variants can also mimic focal masses.
Main body of the abstract
A range of imaging modalities are available to facilitate characterization; ultrasound (US), contrast-enhanced ultrasound (CEUS), computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET), each with their own strengths and limitations. Renal lesions are being detected with increasing frequency due to escalating imaging volumes. Accurate diagnosis is central to guiding clinical management and determining prognosis. Certain lesions require intervention, whereas others may be managed conservatively or deemed clinically insignificant. Challenging cases often benefit from a multimodality imaging approach combining the morphology, enhancement and metabolic features.
Short conclusion
Knowledge of the relevant clinical details and key imaging features is crucial for accurate characterization and differentiation of renal lesions.
Collapse
|
9
|
Bai Y, Lin J, Chen A, Bai M, Li C, Cai Y, Yu J, Hu W, Du L, Li F. Contrast-enhanced ultrasonography promotes differential diagnosis of ureteral neoplasms. Br J Radiol 2021; 94:20210078. [PMID: 34478318 DOI: 10.1259/bjr.20210078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the diagnostic value of contrast-enhanced ultrasonography (CEUS) with baseline ultrasound (B-US) in ureteral neoplasms. METHODS Retrospective analysis, comprising clinical presentation, image appearances, and diagnostic results on B-ultrasound and CEUS, considering pathological result as a gold-standard, was conducted on the clinical information of 39 patients with ureteral neoplasms. CT urography was used to detect and confirm the presence of ureteral neoplasms. Both B-ultrasound and CEUS investigations of those 39 patients under study were performed by a senior radiologist. RESULTS Pathological outcomes established 27 ureteral malignancies and 12 ureteral benignancies. Ureteral malignancies were observed to occur in older patients than benignancies (p = 0.002). Only the morphological indicator of the ureteric wall on B-ultrasound was different in ureteral malignancies and benignancies (p = 0.030). Tumors with hyperenhancement, larger width, and hyperenhanced ureteric wall were easily diagnosed as malignant on CEUS, whereas iso-/hypoenhanced, narrower, and iso-/hypoenhanced ureteric wall indicated benign tumors. Moreover, the lesion widths, enhanced morphologies of the ureteric wall, and the ureteral wall's linear boundaries on CEUS were different between high- and low-stage ureteral urothelial carcinomas (p = 0.012, 0.002, 0.001, respectively). CONCLUSION The display of microvessels in ureteral neoplasms was significantly enhanced by CEUS, thus contributing to the differential diagnosis of ureteral neoplasms while assisting the staging of ureteral urothelial carcinoma. ADVANCES IN KNOWLEDGE The imaging features of different ureteral neoplasms on CEUS were analyzed in this study. The diagnostic performances of CEUS and B-ultrasound in ureteral urothelial carcinomas were also explored.
Collapse
Affiliation(s)
- Yun Bai
- Department of Medical Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Lin
- Department of Pathology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - An Chen
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Bai
- Department of Medical Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunxiao Li
- Department of Medical Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingyu Cai
- Department of Medical Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Yu
- Department of Medical Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjie Hu
- Department of Medical Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lianfang Du
- Department of Medical Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Li
- Department of Medical Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
10
|
Debnath A, Cheriyan A, Gopinathan VR, Kumar S. Adult cystic nephroma masquerading urothelial carcinoma of a calyceal diverticulum. BMJ Case Rep 2021; 14:e245270. [PMID: 34667043 PMCID: PMC8527111 DOI: 10.1136/bcr-2021-245270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 11/04/2022] Open
Abstract
We report a complex cystic renal lesion in a 34-year-old man who presented with haematuria. It was managed by laparoscopic radical nephroureterectomy as it mimicked urothelial carcinoma.
Collapse
Affiliation(s)
- Abhik Debnath
- Department of Urology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Abhilash Cheriyan
- Department of Urology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Vikram Raj Gopinathan
- Department of Pathology, Christian Medical College Vellore, Vellore, Tamil Nadu, India
| | - Santosh Kumar
- Department of Urology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| |
Collapse
|
11
|
Zahid M, Nepal P, Nagar A, Batchala PP, Kumar D, Ojili V. Imaging of ureter: a primer for the emergency radiologist. Emerg Radiol 2021; 28:815-837. [PMID: 33851303 DOI: 10.1007/s10140-021-01930-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/29/2021] [Indexed: 11/28/2022]
Abstract
In this review article, we will discuss the gamut of abnormalities involving the ureters. In the emergency department, ureterolithiasis is the most common indication for imaging abdomen and pelvis. However, spectrum of ureteral abnormalities including congenital, infectious and inflammatory, primary and secondary ureteral malignancies, retroperitoneal fibrosis rare described in this article may be encountered. Thus, we will describe acute subacute as well as chronic conditions that may affect ureter. Knowledge of common, as well as rare entities and their imaging features, is of utmost importance to enable appropriate management.
Collapse
Affiliation(s)
- Mohd Zahid
- Department of Radiology, University of Alabama, Birmingham, AL, USA
| | - Pankaj Nepal
- Department of Radiology, St. Vincent's Medical Center, Bridgeport, CT, USA
| | - Arpit Nagar
- Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Prem P Batchala
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA
| | - Devendra Kumar
- Department of Clinical Imaging, Al Wakra Hospital, Hamad Medical Corporation, Al Wakra, Qatar
| | - Vijayanadh Ojili
- Department of Radiology, University of Texas Health, San Antonio, TX, USA.
| |
Collapse
|
12
|
Wong VK, Ganeshan D, Jensen CT, Devine CE. Imaging and Management of Bladder Cancer. Cancers (Basel) 2021; 13:cancers13061396. [PMID: 33808614 PMCID: PMC8003397 DOI: 10.3390/cancers13061396] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/16/2021] [Indexed: 12/25/2022] Open
Abstract
Simple Summary Bladder cancer is a complex disease, the sixth most common cancer, and one of the most expensive cancers to treat. In the last few decades, there has been a significant decrease in the bladder cancer-related mortality rate, potentially related to decreased smoking prevalence, improvements in diagnosing bladder cancer, and advances in treatment. Those advances in diagnostic tools and therapies and greater understanding of the disease are helping to evolve how bladder cancer is managed. The purpose of this article is to provide a review of bladder cancer pathology, diagnosis, staging, radiologic imaging, and management, and highlight recent developments and research. Abstract Methods: Keyword searches of Medline, PubMed, and the Cochrane Library for manuscripts published in English, and searches of references cited in selected articles to identify additional relevant papers. Abstracts sponsored by various societies including the American Urological Association (AUA), European Association of Urology (EAU), and European Society for Medical Oncology (ESMO) were also searched. Background: Bladder cancer is the sixth most common cancer in the United States, and one of the most expensive in terms of cancer care. The overwhelming majority are urothelial carcinomas, more often non-muscle invasive rather than muscle-invasive. Bladder cancer is usually diagnosed after work up for hematuria. While the workup for gross hematuria remains CT urography and cystoscopy, the workup for microscopic hematuria was recently updated in 2020 by the American Urologic Association with a more risk-based approach. Bladder cancer is confirmed and staged by transurethral resection of bladder tumor. One of the main goals in staging is determining the presence or absence of muscle invasion by tumor which has wide implications in regards to management and prognosis. CT urography is the main imaging technique in the workup of bladder cancer. There is growing interest in advanced imaging techniques such as multiparametric MRI for local staging, as well as standardized imaging and reporting system with the recently created Vesicle Imaging Reporting and Data System (VI-RADS). Therapies for bladder cancer are rapidly evolving with immune checkpoint inhibitors, particularly programmed death ligand 1 (PD-L1) and programmed cell death protein 1 (PD-1) inhibitors, as well as another class of immunotherapy called an antibody-drug conjugate which consists of a cytotoxic drug conjugated to monoclonal antibodies against a specific target. Conclusion: Bladder cancer is a complex disease, and its management is evolving. Advances in therapy, understanding of the disease, and advanced imaging have ushered in a period of rapid change in the care of bladder cancer patients.
Collapse
|
13
|
Abouelkheir RT, Abdelhamid A, Abou El-Ghar M, El-Diasty T. Imaging of Bladder Cancer: Standard Applications and Future Trends. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57030220. [PMID: 33804350 PMCID: PMC8000909 DOI: 10.3390/medicina57030220] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 12/24/2022]
Abstract
The evolution in imaging has had an increasing role in the diagnosis, staging and follow up of bladder cancer. Conventional cystoscopy is crucial in the diagnosis of bladder cancer. However, a cystoscopic procedure cannot always depict carcinoma in situ (CIS) or differentiate benign from malignant tumors prior to biopsy. This review will discuss the standard application, novel imaging modalities and their additive role in patients with bladder cancer. Staging can be performed with CT, but distinguishing between T1 and T2 BCa (bladder cancer) cannot be assessed. MRI can distinguish muscle-invasive from non-muscle-invasive tumors with accurate local staging. Vesical Imaging-Reporting and Data System (VI-RADS) score is a new diagnostic modality used for the prediction of tumor aggressiveness and therapeutic response. Bone scintigraphy is recommended in patients with muscle-invasive BCa with suspected bony metastases. CT shows low sensitivity for nodal staging; however, PET (Positron Emission Tomography)/CT is superior and highly recommended for restaging and determining therapeutic effect. PET/MRI is a new imaging technique in bladder cancer imaging and its role is promising. Texture analysis has shown significant steps in discriminating low-grade from high-grade bladder cancer. Radiomics could be a reliable method for quantitative assessment of the muscle invasion of bladder cancer.
Collapse
|
14
|
Orozco-López AP, Moreno-Mesa D, Saldarriaga-Botero JP, García-Valencia J. Estadificación clínica como factor pronóstico en cáncer de vejiga músculo-invasor. Rev Urol 2021. [DOI: 10.1055/s-0040-1721326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
ResumenEl cáncer de vejiga músculo invasor (CV-MI), requiere de una adecuada estadificación clínica y patológica, ya que eso determina las estrategias terapéuticas y el pronóstico de la enfermedad, caracterizada por una alta morbimortalidad. Este articulo tiene como objetivo realizar una revisión de la literatura sobre la exactitud diagnóstica de las técnicas de imagen disponibles para la estadificación clínica de los pacientes con CV-MI y cómo se debería realizar el seguimiento radiológico en los pacientes llevados a cirugía. Para eso se realizó una búsqueda en la base de datos Pubmed de artículos en inglés y en español, se incluyeron artículos de revisión, metanálisis, guías clínicas, estudios retrospectivos y prospectivos de pronóstico y diagnóstico desde el año 1988 hasta el año 2020.
Collapse
Affiliation(s)
| | - David Moreno-Mesa
- Residente de urología de la Universidad de Antioquia, Medellín, Colombia
| | | | - Jenny García-Valencia
- Psiquiatra, PhD Epidemiología, docente de la facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| |
Collapse
|
15
|
Jindal T, Dhanalakshmi M, Pawar P, Panda J, Midha D. Inflammatory Pseudotumor of the Renal Pelvis. J Endourol Case Rep 2021; 6:405-408. [PMID: 33457686 DOI: 10.1089/cren.2020.0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Inflammatory pseudotumor of the kidney is a rare disease of unknown etiology. There are no specific clinical or radiologic findings. The lesion can mimic renal cell carcinoma or transitional cell carcinoma depending on the site of involvement. These tumors, if diagnosed correctly, may respond to medical management. We present a case in which an inflammatory pseudotumor of the renal pelvis was misdiagnosed as a transitional cell carcinoma and unwarranted surgical intervention was performed. Case Presentation: A 39-year-old man presented with left flank pain and gross hematuria. On MRI, there was a hypointense 2.4 × 1.8 cm lesion involving the left renal pelvis. The urine cytology and biopsy of the lesion were inconclusive. On follow-up cans the lesion increased in size and patient had repeated hematuria. The lesion was clinically presumed to be a transitional cell carcinoma of the left renal pelvis. A laparoscopic left side nephroureterectomy along with bladder cuff excision and para-aortic lymphadenectomy was performed. The histology report revealed the lesion to be inflammatory pseudotumor of the renal pelvis. Conclusion: Inflammatory pseudotumor should always be considered in differential diagnosis of pelvic tumors, especially when image findings and biopsies are inconclusive.
Collapse
Affiliation(s)
- Tarun Jindal
- Department of Uro-Oncology and Tata Medical Center, Kolkata, India
| | - M Dhanalakshmi
- Department of Uro-Oncology and Tata Medical Center, Kolkata, India
| | - Pravin Pawar
- Department of Uro-Oncology and Tata Medical Center, Kolkata, India
| | - Joyshree Panda
- Department of Oncopathology, Tata Medical Center, Kolkata, India
| | - Divya Midha
- Department of Oncopathology, Tata Medical Center, Kolkata, India
| |
Collapse
|
16
|
Sweet DE, Ward RD, Wang Y, Tanaka H, Campbell SC, Remer EM. Infiltrative Renal Malignancies: Imaging Features, Prognostic Implications, and Mimics. Radiographics 2021; 41:487-508. [PMID: 33449838 DOI: 10.1148/rg.2021200123] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Infiltrative renal malignancies are a subset of renal masses that are morphologically characterized by a poorly defined interface with the renal parenchyma. Infiltrative renal malignancies are less common but more aggressive than more typical renal malignancies and carry an overall worse prognosis. Although an infiltrative renal process often represents a malignant neoplasm, infiltrative masses include a wide spectrum of diseases including primary renal cortical, medullary, and pelvic tumors; lymphoproliferative processes; metastases; and various infectious, inflammatory, immune-mediated, and vascular mimics. The imaging features of these masses are often nonspecific, but with the appropriate history, laboratory results, and clinical context, the radiologist can help narrow the diagnosis and guide further treatment. An invited commentary by Lee is available online.Online supplemental material is available for this article. ©RSNA, 2021.
Collapse
Affiliation(s)
- David E Sweet
- From the Imaging Institute (D.E.S., R.D.W., E.M.R.) and Glickman Urological and Kidney Institute (Y.W., H.T., S.C.C., E.M.R.), Cleveland Clinic, 9500 Euclid Ave, L10, Cleveland, OH 44195; Department of Urology, First Hospital of Jilin University, Changchun, China (Y.W.); and Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan (H.T.)
| | - Ryan D Ward
- From the Imaging Institute (D.E.S., R.D.W., E.M.R.) and Glickman Urological and Kidney Institute (Y.W., H.T., S.C.C., E.M.R.), Cleveland Clinic, 9500 Euclid Ave, L10, Cleveland, OH 44195; Department of Urology, First Hospital of Jilin University, Changchun, China (Y.W.); and Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan (H.T.)
| | - Yanbo Wang
- From the Imaging Institute (D.E.S., R.D.W., E.M.R.) and Glickman Urological and Kidney Institute (Y.W., H.T., S.C.C., E.M.R.), Cleveland Clinic, 9500 Euclid Ave, L10, Cleveland, OH 44195; Department of Urology, First Hospital of Jilin University, Changchun, China (Y.W.); and Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan (H.T.)
| | - Hajime Tanaka
- From the Imaging Institute (D.E.S., R.D.W., E.M.R.) and Glickman Urological and Kidney Institute (Y.W., H.T., S.C.C., E.M.R.), Cleveland Clinic, 9500 Euclid Ave, L10, Cleveland, OH 44195; Department of Urology, First Hospital of Jilin University, Changchun, China (Y.W.); and Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan (H.T.)
| | - Steven C Campbell
- From the Imaging Institute (D.E.S., R.D.W., E.M.R.) and Glickman Urological and Kidney Institute (Y.W., H.T., S.C.C., E.M.R.), Cleveland Clinic, 9500 Euclid Ave, L10, Cleveland, OH 44195; Department of Urology, First Hospital of Jilin University, Changchun, China (Y.W.); and Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan (H.T.)
| | - Erick M Remer
- From the Imaging Institute (D.E.S., R.D.W., E.M.R.) and Glickman Urological and Kidney Institute (Y.W., H.T., S.C.C., E.M.R.), Cleveland Clinic, 9500 Euclid Ave, L10, Cleveland, OH 44195; Department of Urology, First Hospital of Jilin University, Changchun, China (Y.W.); and Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan (H.T.)
| |
Collapse
|
17
|
|
18
|
Kim DW, Yoon SK, Kim SH. Urothelial Carcinoma of the Bladder: Radiologic Perspective. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2021; 82:1033-1052. [PMID: 36238404 PMCID: PMC9432377 DOI: 10.3348/jksr.2021.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/19/2021] [Accepted: 08/12/2021] [Indexed: 11/19/2022]
Abstract
방광암은 비교적 흔히 진단되는 암이며 재발이 흔해 영상의학적 검사에서 흔히 만날 수 있다. 방광암의 정확한 진단과 병기 평가는 어떤 치료를 할 것인지를 정하고 예후를 평가하는데 큰 영향을 미친다. 방광암의 임상적 병기 평가는 요도경유방광종양절제술로 진단과 치료를 겸해서 이루어졌지만, 저평가되는 경우가 흔히 있다. 수술 전 방광암의 위치, 크기, 근육층 침범 유무, 림프절전이, 원격전이, 상부요로 암 유무 등을 영상의학적 검사에서 정확히 진단 및 평가할 수 있다면 더욱 적절히 처치 및 관리를 할 수 있다. 이런 정확한 진단을 위해서는 영상을 판독하는 영상의학과 의사는 먼저 방광암의 임상적인 특징을 잘 알고 있어야 한다. 그리고 영상 검사들의 종류와 특징, 한계를 알고 있어야 한다. 최근 자기공명영상의 발달로 방광 영상의 질 및 방광암의 진단과 평가가 향상되었다. 그리고 방광 이미징 보고 및 데이터시스템이 발표되어 객관적으로 방광암의 근육층 침범 가능성을 평가할 수 있게 되었다. 방광암 치료 종류를 알고 그에 따른 치료 후 변화에는 무엇이 있는지 어떻게 평가하는지도 알아야 하겠다. 이 종설에서는 방광 요로상피세포암의 특징과 다양한 영상의학 검사와 소견에 대해서 알아보고자 한다.
Collapse
Affiliation(s)
- Dong Won Kim
- Department of Radiology, Dong-A University College of Medicine, Busan, Korea
| | - Seong Kuk Yoon
- Department of Radiology, Dong-A University College of Medicine, Busan, Korea
| | - Sang Hyeon Kim
- Department of Radiology, Dong-A University College of Medicine, Busan, Korea
| |
Collapse
|
19
|
Martingano P, Cavallaro MFM, Bozzato AM, Baratella E, Cova MA. CT Urography Findings of Upper Urinary Tract Carcinoma and Its Mimickers: A Pictorial Review. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E705. [PMID: 33348865 PMCID: PMC7766367 DOI: 10.3390/medicina56120705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 11/17/2022]
Abstract
Urothelial carcinoma (UC) is the fourth most frequent tumor in Western countries and upper tract urothelial carcinoma (UTUC), affecting pyelocaliceal cavities and ureter, accounts for 5-10% of all UCs. Computed tomography urography (CTU) is now considered the imaging modality of choice for diagnosis and staging of UTUC, guiding disease management. Although its specificity is very high, both benign and malignant diseases could mimic UTUCs and therefore have to be well-known to avoid misdiagnosis. We describe CTU findings of upper urinary tract carcinoma, features that influence disease management, and possible differential diagnosis.
Collapse
Affiliation(s)
- Paola Martingano
- Department of Radiology, ASUGI, Cattinara Hospital, 34139 Trieste, Italy
| | | | - Alessandro M. Bozzato
- Department of Radiology, University of Trieste, ASUGI, Cattinara Hospital, 34139 Trieste, Italy; (A.M.B.); (E.B.); (M.A.C.)
| | - Elisa Baratella
- Department of Radiology, University of Trieste, ASUGI, Cattinara Hospital, 34139 Trieste, Italy; (A.M.B.); (E.B.); (M.A.C.)
| | - Maria A. Cova
- Department of Radiology, University of Trieste, ASUGI, Cattinara Hospital, 34139 Trieste, Italy; (A.M.B.); (E.B.); (M.A.C.)
| |
Collapse
|
20
|
An T, Kwon GY, Min JH, Park SY. Ureteral cancer: Complete ureteral obstruction on computed tomography urography is associated with periureteral fat invasion. Eur J Radiol 2020; 130:109198. [PMID: 32738463 DOI: 10.1016/j.ejrad.2020.109198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/12/2020] [Accepted: 07/16/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine predictive factors for periureteral fat invasion of ureteral cancer on computed tomography (CT) urography. MATERIALS AND METHODS Consecutive 77 patients with CT urography and surgically proven ureteral cancer were retrospectively evaluated. Three independent radiologists with different experiences in interpreting CT urography analyzed radiologic findings as follows: (a) periureteral infiltration (absent; equivocal; or present); (b) ureteral obstruction (complete obstruction or not); (c) lesion length; (d) lesion width; (e) hydronephrosis grade; and (f) renal atrophy (present or not). We analyzed univariate and multivariate logistic regression. We assessed sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of significant parameters. RESULTS Periureteral fat invasion was surgically identified in 33.8 % (26/77). For reader 1, periureteral infiltration (odds ratio [OR] = 3.330), complete ureteral obstruction (OR = 18.965), and renal atrophy (OR = 3.116) were significant in univariate analysis (p < 0.05), while only complete ureteral obstruction was significant in multivariate analysis (OR = 12.779; p = 0.018). For reader 2 (OR = 4.172; p = 0.019) and 3 (OR = 9.459; p = 0.035), only complete ureteral obstruction was significant in univariate analysis. Sensitivity, specificity, PPV, and NPV of complete ureteral obstruction were 96.2 % (25/26), 43.1 % (22/51), 46.3 % (25/54), and 95.7 % (22/23) for reader 1, 84.6 % (22/26), 43.1 % (22/51), 43.1 % (22/51), and 84.6 % (22/26) for reader 2, and 96.2 % (25/26), 27.5 % (14/51), 40.3 % (25/62), and 93.3 % (14/15) for reader 3, respectively. CONCLUSION Complete ureteral obstruction on CT urography is highly sensitive for extra-ureteral extension of ureteral cancer. Ureteral cancer without complete ureteral obstruction may be less likely to invade periureteral fat.
Collapse
Affiliation(s)
- Taein An
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ghee Young Kwon
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Hye Min
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Yoon Park
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
21
|
Zulfiqar M, Ubilla CV, Nicola R, Menias CO. Imaging of Renal Infections and Inflammatory Disease. Radiol Clin North Am 2020; 58:909-923. [PMID: 32792123 DOI: 10.1016/j.rcl.2020.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Acute pyelonephritis is a bacterial infection of the renal parenchyma and collecting system. Diagnosis is based on clinical findings of fever, flank pain, and urinary tract infection. Computed tomography findings include renal enlargement with wedge-shaped heterogeneous areas of decreased enhancement, known as a "striated nephrogram." Imaging is primarily used to diagnose complications such as emphysematous pyelonephritis, renal abscess, and pyonephrosis. Chronic pyelonephritis can have varying appearances on imaging ranging from xanthogranulomatous pyelonephritis or, in extreme cases, renal replacement lipomatosis.
Collapse
Affiliation(s)
- Maria Zulfiqar
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, St Louis, MO 63110, USA.
| | - Cristián Varela Ubilla
- Radiology Department, Clinica Davila, Avenida Recoleta 464, Recoleta, Santiago 8431657, Chile
| | - Refky Nicola
- Division of Body Imaging, Department of Radiology, Roswell Park Cancer Institute, Elm and Carlton Street, Buffalo, NY 14203, USA
| | - Christine O Menias
- Mayo Clinic School of Medicine, Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA
| |
Collapse
|
22
|
Upper urinary tract urothelial carcinoma on multidetector CT: spectrum of disease. Abdom Radiol (NY) 2019; 44:3874-3885. [PMID: 31440804 DOI: 10.1007/s00261-019-02173-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Urothelial carcinoma of the upper urinary tract (UUT) is a relatively uncommon genitourinary malignancy, accounting for about 5-7% of urothelial tumors. The significant features of this tumor are multifocality and high rate of recurrence. Computed tomography urography (CTU) has replaced excretory urography (EU) and retrograde pyelography (RP) for imaging of upper tract urothelial carcinoma. While many studies have confirmed high sensitivity (88-100%) and specificity (93-100%) of CTU, an optimized CT protocol is of critical importance in screening, staging, and post-operative follow-up of patients (Chlapoutakis, Eur J Radiol 73(2):334-338, 2010; Caoli and Cohan, Abdom Radiol (NY) 41(6):1100-1107, 2016). The key element of the CT protocol is to have adequate distension of the collecting system with excreted contrast, to detect subtle lesions at an early stage. In this article, we discuss the background of upper urinary tract TTC, pathogenesis, CT protocol and the role of imaging in evaluation of this malignancy, staging, as well as different imaging appearances.
Collapse
|
23
|
Honda Y, Nakamura Y, Teishima J, Goto K, Higaki T, Narita K, Akagi M, Terada H, Kaichi Y, Fujii S, Hayashi T, Matsubara A, Sentani K, Yasui W, Iida M, Awai K. Clinical staging of upper urinary tract urothelial carcinoma for T staging: Review and pictorial essay. Int J Urol 2019; 26:1024-1032. [PMID: 31379021 DOI: 10.1111/iju.14068] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/18/2019] [Indexed: 12/17/2022]
Abstract
Upper urinary tract urothelial carcinoma is staged using the TNM classification of malignant tumors. Preoperative TNM is important for treatment planning. Computed tomography urography is now widely used for clinical survey of upper urinary tract carcinoma because of its diagnostic accuracy. Computed tomography urography is recommended as the first-line imaging procedure in several guidelines. Several reports stated that computed tomography urography is also useful for staging. However, no educational and practical reviews detailing the T staging of upper urinary tract urothelial carcinomas using imaging are available. We discuss the scanning protocol, T staging using computed tomography urography, limitations, magnetic resonance imaging, computed tomography comparison and pitfalls in imaging of upper urinary tract urothelial carcinoma. A recent study reported the high diagnostic accuracy of computed tomography urography with respect to T3 or higher stage tumors. To date, images that show a Tis-T2 stage have not been reported, but various studies are ongoing. Although magnetic resonance imaging has lower spatial resolution than computed tomography urography, magnetic resonance imaging can be carried out without radiation exposure or contrast agents. Magnetic resonance imaging also offers the unique ability of diffusion-weighted imaging without contrast agent use. Some researchers reported that diffusion-weighted imaging is useful not only for detecting lesions, but for predicting the T stage and tumor grade. We recommend the appropriate use of computed tomography and magnetic resonance while considering the limitations of each modality and the pitfalls in upper urinary tract urothelial carcinoma imaging.
Collapse
Affiliation(s)
- Yukiko Honda
- Department of Diagnostic Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuko Nakamura
- Department of Diagnostic Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Jun Teishima
- Department of Urology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keisuke Goto
- Department of Urology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toru Higaki
- Department of Diagnostic Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keigo Narita
- Department of Diagnostic Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Motonori Akagi
- Department of Diagnostic Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroaki Terada
- Department of Diagnostic Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoko Kaichi
- Department of Diagnostic Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinsuke Fujii
- Department of Urology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tetsutaro Hayashi
- Department of Urology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akio Matsubara
- Department of Urology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Sentani
- Department of Molecular Pathology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Wataru Yasui
- Department of Molecular Pathology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Iida
- Department of Diagnostic Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
24
|
Matteo M, Elena B, Cristina BM, Ginevra D, Costanza V, Simone A, Vittorio M. Rare case of an upper urinary tract carcinoma (UTUC) in renal pelvis and ureter associated to renal vein thrombosis: diagnostic imaging with CECT, MRI and CEUS. J Ultrasound 2019; 22:373-379. [PMID: 31243704 DOI: 10.1007/s40477-019-00396-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/18/2019] [Indexed: 01/14/2023] Open
Abstract
A 58-year-old woman complaining of dyspnea and mild flank pain was admitted to our radiology department after undergoing ultrasonography in another institution. She showed hydronephrosis and left kidney swelling. We performed a contrast-enhanced computed tomography (CECT) that confirmed the hydronephrosis and revealed a widely hypoperfused left kidney, a concentric thickening of the proximal ureter, and a slight and diffuse thickening of the renal pelvic wall, with a hyperdense content in the unenhanced CT phase and poor contrast enhancement in the post-contrast phases. A proximal ipsilateral renal vein thrombosis was associated. Non-contrast magnetic resonance imaging confirmed the CECT findings. At the same time, we performed a contrast-enhanced ultrasonography examination, which proved to be helpful for the characterization of the lesion and for patient management.
Collapse
Affiliation(s)
- Mastrorosato Matteo
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo G.A. Brambilla 3, 50134, Florence, Italy
| | - Bertelli Elena
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo G.A. Brambilla 3, 50134, Florence, Italy
| | - Bonini Maria Cristina
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo G.A. Brambilla 3, 50134, Florence, Italy
| | - Danti Ginevra
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo G.A. Brambilla 3, 50134, Florence, Italy.
| | - Vannini Costanza
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo G.A. Brambilla 3, 50134, Florence, Italy
| | - Agostini Simone
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo G.A. Brambilla 3, 50134, Florence, Italy
| | - Miele Vittorio
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo G.A. Brambilla 3, 50134, Florence, Italy
| |
Collapse
|
25
|
Increased urinary bladder volume improves the detectability of urinary stones at the ureterovesical junction in non-enhanced computed tomography (NECT). Eur Radiol 2019; 29:6953-6964. [PMID: 31209621 DOI: 10.1007/s00330-019-06279-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/08/2019] [Accepted: 05/17/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To evaluate the influence of the urinary bladder volume on the detectability of urolithiasis at the ureterovesical junction (UVJ) using a low-dose CT (LD-CT) with iterative reconstruction (IR) and a standard-dose CT (SD-CT) without IR in a large cohort. METHODS Four hundred patients (278 males (69.5%), mean 44.6 ± 14.7 years) with urolithiasis at the UVJ were investigated either by an LD-CT with IR (n = 289, 72%) or an SD-CT without IR (n = 111, 28%) protocol. The detectability of distal urolithiasis was assessed by a dichotomous assessment (definite or questionable) by two radiologists in consensus and by a quantitative analysis of the signal density distribution across a line drawn parallel to the distal ureter. Based on the resulting graph, minimum/maximum density values and mean/maximum upslopes and downslopes were derived and calculated automatically. In all patients, the total bladder volume was calculated by a slice-by-slice approach on axial CT images. RESULTS Patients with definite stones showed significantly higher urinary bladder volumes compared to patients with questionable stones in both LD-CT and SD-CT (p < 0.01). These results were independent of stones' length and patients' BMI values. Using cutoffs of 92 ml for LD-CT and 69 ml for SD-CT, high positive predictive values/accuracy rates of 96%/85% (LD-CT) and 98%/86% (SD-CT) were observed to identify definite urinary stones. CONCLUSIONS Urinary bladder volume has a significant impact on the detectability of distal urolithiasis. Moderate bladder filling by pre-CT hydration with subsequent CT scan at the time of high urge to void increases the detectability of urinary stones at the UVJ in clinical routine. KEY POINTS • Urinary bladder volume significantly affects the detectability of distal urolithiasis • Higher bladder volumes are associated with improved detectability of distal urinary stones • Oral pre-CT hydration for urolithiasis is easily applicable and cost-effective.
Collapse
|
26
|
|
27
|
The "phantom" calyx. Abdom Radiol (NY) 2019; 44:1951-1952. [PMID: 30725126 DOI: 10.1007/s00261-019-01917-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
28
|
Abstract
OPINION STATEMENT Upper tract urothelial carcinoma (UTUC) is a rare genitourinary entity of the renal pelvis and the ureter characterized by a more aggressive disease phenotype when compared with urothelial carcinoma of the bladder (UCB) with more than half of UTUC cases presenting with invasive disease at diagnosis compared to 20% for bladder tumors. There is growing evidence suggesting that its distinct natural history from that of bladder cancer can be related to several genetic and epigenetic differences. Treatment of low-risk disease consists of kidney-sparing surgeries such as ureteroscopic and percutaneous treatments, segmental ureterectomy, and adjuvant topical and intracavitary chemo-immunotherapies. The standard of care for high-risk non-metastatic disease remains radical nephroureterectomy and bladder cuff excision with increasing utilization rates of minimally invasive approaches leading to reduced morbidity without compromising outcomes while the role of lymphadenectomy is still being investigated. The prognosis of UTUC has been stagnant over the past decade highlighting the need for further studies on the role of multimodal therapy (neoadjuvant/adjuvant chemotherapy, immunotherapy, targeted therapy) to optimize management and improve outcomes.
Collapse
|
29
|
Evaluation of upper tract urothelial carcinomas by contrast-enhanced ultrasound. RADIOLOGIA 2018. [DOI: 10.1016/j.rxeng.2018.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
30
|
Leffler AJ, Hostnik ET, Warry EE, Habing GG, Auld DM, Green EM, Drost WT. Canine urinary bladder transitional cell carcinoma tumor volume is dependent on imaging modality and measurement technique. Vet Radiol Ultrasound 2018; 59:767-776. [PMID: 29989254 PMCID: PMC6218272 DOI: 10.1111/vru.12652] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 02/20/2018] [Accepted: 03/23/2018] [Indexed: 12/19/2022] Open
Abstract
Transitional cell carcinoma is the most common cancer of the canine urinary tract. The inconsistent appearance of transitional cell carcinoma in patients introduces error if applying mathematic models for extrapolating total tumor volume from linear measurements. Reliable techniques to assess tumor size are important for monitoring treatment response. A method comparison study was performed comparing four techniques for calculating tumor volume were compared: (1 and 2) contoured tracing of tumor margins using serial computed tomography (CT) images using pre-(1) and postintravenous (2) contrast medium studies, (3) longest three linear dimensions using CT, and (4) longest three linear dimensions on abdominal ultrasound. Volumes of the transitional cell carcinoma tumor calculated by CT tracing techniques were significantly smaller than volumes calculated with an ellipsoid mathematic model using the linear measurements (P < 0.01). Intravenous contrast medium did not significantly change the volumes calculated from tracing tumor margins on CT for observer B; however, volumes differed for observer A. The volumes extrapolated from linear measurements using CT and ultrasound did not differ significantly. The interobserver reliability was highest for the precontrast CT contoured technique and was lowest using the ultrasound linear technique. Tumor volumes differed significantly between techniques of contoured tracing of the tumor margins on serial CT images compared to calculation of tumor volume from linear dimensions. The calculated volume of a transitional cell carcinoma depends upon the technique used. Characterizing the response of urinary bladder transitional cell carcinoma tumor size to therapy differs based on the method and modality used.
Collapse
Affiliation(s)
- Andrew J. Leffler
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Eric T. Hostnik
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Emma E. Warry
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Gregory G. Habing
- Department of Preventative Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Danelle M. Auld
- Diagnostic Imaging and Radiation Oncology, Veterinary Medical Center, The Ohio State University, Columbus, OH 43210
| | - Eric M. Green
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Wm Tod Drost
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| |
Collapse
|
31
|
Painel Seguel AA, Martínez Pérez MJ, Ripollés González T, Gómez DP, Vizuete Del Río J, Martín Benítez G. Evaluation of upper tract urothelial carcinomas by contrast-enhanced ultrasound. RADIOLOGIA 2018; 60:496-503. [PMID: 30266206 DOI: 10.1016/j.rx.2018.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 05/30/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022]
Abstract
AIM To describe the findings and behaviour of contrast-enhanced ultrasound in the study of upper tract urothelial tumours and to assess its usefulness for diagnosis. MATERIAL AND METHODS We reviewed our hospital's database over a period of 45 months to identify patients diagnosed with upper tract urothelial carcinomas. We reviewed the findings on mode B-ultrasound, contrast-enhanced ultrasound (location and qualitative assessment of intensity and washout of enhancement), and made a comparison with other techniques (computed tomography or magnetic resonance), and with the surgical specimen. RESULTS We found 42 patients with a diagnosis of upper tract urothelial carcinoma confirmed with surgery over the period reviewed. Twenty-eight (67%) patients underwent contrast-enhanced ultrasound. Baseline ultrasound showed hydronephrosis with or without ureteral dilatation with echogenic content occupying the renal calyx (6), pelvis (10) or ureter (12). After injection of contrast, enhancement was noticed in 100% of the lesions, with similar intensity to the cortex in 23, and less in 5. Twenty-four lesions showed early washout, before the cortex, between 40 and 55seconds after the injection. The diagnosis was correct in 27 cases. Localisation coincided with the histological specimen in 28 cases, and 3 patients had additional distal carcinoma foci. CONCLUSION Contrast-enhanced ultrasound is a useful technique for diagnosing upper tract urothelial tumours that increases confidence in the diagnosis.
Collapse
Affiliation(s)
- A A Painel Seguel
- Servicio de Radiodiagnóstico, Hospital Universitario Doctor Peset, Valencia, España.
| | - M J Martínez Pérez
- Servicio de Radiodiagnóstico, Hospital Universitario Doctor Peset, Valencia, España
| | - T Ripollés González
- Servicio de Radiodiagnóstico, Hospital Universitario Doctor Peset, Valencia, España
| | - D P Gómez
- Servicio de Radiodiagnóstico, Hospital Universitario Doctor Peset, Valencia, España
| | - J Vizuete Del Río
- Servicio de Radiodiagnóstico, Hospital Universitario Doctor Peset, Valencia, España
| | - G Martín Benítez
- Servicio de Radiodiagnóstico, Hospital Universitario Doctor Peset, Valencia, España
| |
Collapse
|
32
|
Farnum JA, Vikram R, Rao A, Bedi D, Dinney CP, Matin SF. Accuracy of High-Frequency Endoluminal Ultrasonography for Clinical Staging of Upper Tract Urothelial Carcinoma. J Endourol 2018; 32:806-811. [PMID: 30014707 DOI: 10.1089/end.2018.0442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Staging of upper tract urothelial carcinoma (UTUC) remains a dilemma due to imaging and biopsy limitations leading to understaging. We seek to determine the accuracy of endoluminal ultrasound (ELUS) for clinical staging of UTUC. MATERIALS AND METHODS Patients evaluated for UTUC underwent retrograde pyelography, ureteroscopy, and ELUS. ELUS was performed using mechanical radial scanning at 20 MHz in B-mode with a 5F probe. Cine clips were evaluated by 2 radiologists blinded to ureteroscopic and pathology findings. Results were compared to pathology from nephroureterectomy. Inclusion criteria were patients who underwent nephroureterectomy without pretreatment or managed endoscopically for cTa-1 disease and were without recurrence for >1 year. RESULTS From 2008 to 2013, 53 patients underwent ELUS without complication. Twenty-seven patients met inclusion criteria with conclusive ELUS imaging. ELUS accurately identified 16 of 21 patients with non-muscle invasive (MI) disease (18 pTa, 2 pT1, 1 CIS) and 1 of 6 patients with at least MI disease (2 pT2, 4 pT3). For MI disease, the positive predictive value (PPV), negative predictive value, and accuracy was 76.2%, 16.7%, and 63%, respectively, while for non-organ confined (OC) disease results were 0%, 81.8%, and 66.7%, respectively. CONCLUSIONS With current technique and instrumentation, ELUS may prove useful in select cases to confirm findings of non-MI and OC disease. However, it has insufficient PPV for stage pT2-3 disease. Further studies and better instrumentation are needed before incorporation into clinical practice.
Collapse
Affiliation(s)
- Jeffrey A Farnum
- 1 Department of Urology, University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Raghunandan Vikram
- 2 Department of Diagnostic Imaging, University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Arvind Rao
- 3 Department of Biostatistics, University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Deepak Bedi
- 2 Department of Diagnostic Imaging, University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Colin P Dinney
- 1 Department of Urology, University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Surena F Matin
- 1 Department of Urology, University of Texas MD Anderson Cancer Center , Houston, Texas
| |
Collapse
|
33
|
Agha M, Eid AF. 64 MS-CTU: Review of techniques and spectrum of the ureteric diseases. ALEXANDRIA JOURNAL OF MEDICINE 2018. [DOI: 10.1016/j.ajme.2017.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Mahmoud Agha
- Medical Research Institute, Alexandria University, EgyptMedical Research Institute, Alexandria University, Egypt
- Almana General Hospital, Saudi ArabiaAlmana General Hospital, Saudi Arabia
| | - Ahmed Fathi Eid
- National Guard Hospital, Saudi ArabiaNational Guard Hospital, Saudi Arabia
| |
Collapse
|
34
|
Cox VL, Saeed Bamashmos AA, Foo WC, Gupta S, Yedururi S, Garg N, Kang HC. Lynch Syndrome: Genomics Update and Imaging Review. Radiographics 2018. [PMID: 29528821 DOI: 10.1148/rg.2018170075] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Lynch syndrome is the most common hereditary cancer syndrome, the most common cause of heritable colorectal cancer, and the only known heritable cause of endometrial cancer. Other cancers associated with Lynch syndrome include cancers of the ovary, stomach, urothelial tract, and small bowel, and less frequently, cancers of the brain, biliary tract, pancreas, and prostate. The oncogenic tendency of Lynch syndrome stems from a set of genomic alterations of mismatch repair proteins. Defunct mismatch repair proteins cause unusually high instability of regions of the genome called microsatellites. Over time, the accumulation of mutations in microsatellites and elsewhere in the genome can affect the production of important cellular proteins, spurring tumorigenesis. Universal testing of colorectal tumors for microsatellite instability (MSI) is now recommended to (a) prevent cases of Lynch syndrome being missed owing to the use of clinical criteria alone, (b) reduce morbidity and mortality among the relatives of affected individuals, and (c) guide management decisions. Organ-specific cancer risks and associated screening paradigms vary according to the sex of the affected individual and the type of germline DNA alteration causing the MSI. Furthermore, Lynch syndrome-associated cancers have different pathologic, radiologic, and clinical features compared with their sporadic counterparts. Most notably, Lynch syndrome-associated tumors tend to be more indolent than non-Lynch syndrome-associated neoplasms and thus may respond differently to traditional chemotherapy regimens. The high MSI in cases of colorectal cancer reflects a difference in the biologic features of the tumor, possibly with a unique susceptibility to immunotherapy. ©RSNA, 2018.
Collapse
Affiliation(s)
- Veronica L Cox
- From the Departments of Radiology (V.L.C., A.A.S.B., S.G., S.Y., N.G., H.C.K.) and Pathology (W.C.F.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1459, Houston, TX 77030
| | - Anas A Saeed Bamashmos
- From the Departments of Radiology (V.L.C., A.A.S.B., S.G., S.Y., N.G., H.C.K.) and Pathology (W.C.F.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1459, Houston, TX 77030
| | - Wai Chin Foo
- From the Departments of Radiology (V.L.C., A.A.S.B., S.G., S.Y., N.G., H.C.K.) and Pathology (W.C.F.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1459, Houston, TX 77030
| | - Shiva Gupta
- From the Departments of Radiology (V.L.C., A.A.S.B., S.G., S.Y., N.G., H.C.K.) and Pathology (W.C.F.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1459, Houston, TX 77030
| | - Sireesha Yedururi
- From the Departments of Radiology (V.L.C., A.A.S.B., S.G., S.Y., N.G., H.C.K.) and Pathology (W.C.F.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1459, Houston, TX 77030
| | - Naveen Garg
- From the Departments of Radiology (V.L.C., A.A.S.B., S.G., S.Y., N.G., H.C.K.) and Pathology (W.C.F.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1459, Houston, TX 77030
| | - Hyunseon Christine Kang
- From the Departments of Radiology (V.L.C., A.A.S.B., S.G., S.Y., N.G., H.C.K.) and Pathology (W.C.F.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1459, Houston, TX 77030
| |
Collapse
|
35
|
Batura D, Hashemzehi T, Gayed W. Should contrast CT urography replace non-contrast CT as an investigation for ureteric colic in the emergency department in those aged 65 and over? Emerg Radiol 2018; 25:621-626. [DOI: 10.1007/s10140-018-1620-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/20/2018] [Indexed: 10/28/2022]
|
36
|
Furuya S, Manabe O, Nanbu T, Yamashita N, Shinnno Y, Kasai K, Kroenke M, Tamaki N. Renal Mucinous Tubular and Spindle Cell Carcinoma Shows a High Uptake on 18F-FDG PET/CT. Intern Med 2018; 57:1131-1134. [PMID: 29279490 PMCID: PMC5938505 DOI: 10.2169/internalmedicine.9523-17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We herein report a rare case of mucinous tubular and spindle cell carcinoma (MTSCC) in an 80-year-old woman. A well circumscribed tumor located on the right kidney was discovered incidentally as a result of screening non-contrast CT. Fluorodeoxyglucose positron emission tomography (FDG PET)/CT showed the increased tracer accumulation in the tumor. The histological diagnosis was MTSCC, which is a rare and only recently established subtype of the malignant renal cell carcinoma (RCC). The present case suggests the clinical benefit of a high uptake of FDG combined with enhanced contrast CT in the differentiation of MTSCCs and other RCCs.
Collapse
Affiliation(s)
- Sho Furuya
- Department of Radiology, Otaru General Hospital, Japan
| | - Osamu Manabe
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Japan
| | | | | | | | - Kiyoshi Kasai
- Department of Diagnostic Pathology, Otaru General Hospital, Japan
| | - Markus Kroenke
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Japan
- Department of Nuclear Medicine, Rechts Der Isar Hospital, Technical University of Munich, Germany
| | - Nagara Tamaki
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Japan
| |
Collapse
|
37
|
Hartman R, Kawashima A. Lower tract neoplasm: Update of imaging evaluation. Eur J Radiol 2017; 97:119-130. [PMID: 29102424 DOI: 10.1016/j.ejrad.2017.10.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 10/24/2017] [Indexed: 01/13/2023]
Abstract
Cancers of the lower urinary tract can arise from the bladder, urachus or urethra. Urothelial carcinoma of the bladder (UCB) is the most common of these. The presentation of bladder, urachal and urethral cancers can differ but many result in hematuria as an initial indication. The diagnosis and staging of these cancers often necessitate radiologic imaging often in the form of cross-section CT urography or MR urography. The following article reviews the specific nature of lower tract cancers and their imaging.
Collapse
Affiliation(s)
- Robert Hartman
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
| | | |
Collapse
|
38
|
Ballard DH, De Alba L, Migliaro M, Previgliano CH, Sangster GP. CT imaging spectrum of infiltrative renal diseases. Abdom Radiol (NY) 2017; 42:2700-2709. [PMID: 28580537 DOI: 10.1007/s00261-017-1193-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Most renal lesions replace the renal parenchyma as a focal space-occupying mass with borders distinguishing the mass from normal parenchyma. However, some renal lesions exhibit interstitial infiltration-a process that permeates the renal parenchyma by using the normal renal architecture for growth. These infiltrative lesions frequently show nonspecific patterns that lead to little or no contour deformity and have ill-defined borders on CT, making detection and diagnosis challenging. The purpose of this pictorial essay is to describe the CT imaging findings of various conditions that may manifest as infiltrative renal lesions.
Collapse
Affiliation(s)
- David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St. Louis, MO, 63110, USA
| | - Luis De Alba
- Department of Radiology, Louisiana State University Health Shreveport, 1501 Kings Hwy, Shreveport, LA, 71103, USA
| | - Matias Migliaro
- Department of Radiology, Hospital Santa Isabel de Hungria, 2854 Pedro del Castillo, Guaymallen, 5521, Mendoza, Argentina
| | - Carlos H Previgliano
- Department of Radiology, Louisiana State University Health Shreveport, 1501 Kings Hwy, Shreveport, LA, 71103, USA
| | - Guillermo P Sangster
- Department of Radiology, Louisiana State University Health Shreveport, 1501 Kings Hwy, Shreveport, LA, 71103, USA.
| |
Collapse
|
39
|
Multidetector Computed Tomographic Urography (MDCTU): Its Practical Role in Diagnosis of Upper Tract Urothelial Cancer in Patients 50 years and Older with Different Types of Hematuria. Pathol Oncol Res 2017; 25:249-254. [DOI: 10.1007/s12253-017-0333-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022]
|
40
|
Harri PA, Alexander L, Camacho JC, Moreno CC, Mittal P. Magnetic Resonance Imaging Evaluation of Urothelial Cell Carcinoma: Histopathological Correlation, Staging, and Treatment Planning. Curr Probl Diagn Radiol 2017; 47:28-41. [PMID: 28571907 DOI: 10.1067/j.cpradiol.2017.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 04/12/2017] [Accepted: 04/12/2017] [Indexed: 11/22/2022]
Affiliation(s)
- Peter A Harri
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA.
| | - Lauren Alexander
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
| | - Juan C Camacho
- Department of Radiology, Medical University of South Carolina, Charleston, SC
| | - Courtney C Moreno
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
| | - Pardeep Mittal
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
| |
Collapse
|
41
|
Role of Imaging in the Local Staging of Urothelial Carcinoma of the Bladder. AJR Am J Roentgenol 2017; 208:1193-1205. [DOI: 10.2214/ajr.16.17114] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
42
|
Sountoulides P, Mykoniatis I, Metaxa L. Non-visible asymptomatic haematuria: a review of the guidelines from the urologist’s perspective. Expert Rev Anticancer Ther 2017; 17:203-216. [DOI: 10.1080/14737140.2017.1284589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Petros Sountoulides
- Department of Urology, The Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - Ioannis Mykoniatis
- 1st Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Linda Metaxa
- Department of Radiology, St. Bartholomew’s Hospital, London, England
| |
Collapse
|
43
|
MicroRNA promoter methylation: a new tool for accurate detection of urothelial carcinoma. Br J Cancer 2017; 116:634-639. [PMID: 28081549 PMCID: PMC5344289 DOI: 10.1038/bjc.2016.454] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 11/14/2016] [Accepted: 12/20/2016] [Indexed: 01/08/2023] Open
Abstract
Background: Urothelial carcinoma (UC) is the most common cancer affecting the urinary system, worldwide. Lack of accurate early detection tools entails delayed diagnosis, precluding more efficient and timely treatment. In a previous study, we found that miR-129-2 and miR-663a were differentially methylated in UC compared with other genitourinary tract malignancies. Here, we evaluated the diagnostic performance of those microRNAs in urine. Methods: Promoter methylation levels of miR-129-2 and miR-663a were assessed, using real-time quantitative methylation-specific PCR, in UC tissue samples (using normal urothelium as control) and, subsequently, in urine samples from UC and other genitourinary malignancies. Diagnostic and prognostic performances were evaluated by receiver operator characteristics curve and survival analyses, respectively. Results: Promoter methylation levels of both microRNAs were significantly higher in UC tissue samples compared with normal urothelium. In urine, the assay was able to distinguish UC from other genitourinary tract carcinomas with 87.7% sensitivity and 84% specificity, resulting in 85.85% overall accuracy. Conclusions: This panel of miRNAs promoter methylation accurately detects UC in urine, comparing well with other promising epigenetic-based biomarkers. This may constitute the basis for a non-invasive assay to detect UC.
Collapse
|
44
|
Parikesit D, Mochtar CA, Tanurahardja B, Matondang S, Umbas R, Hamid AR. Thrombus-like Tumor of Renal Cell Carcinoma Mimicking Transitional Cell Carcinoma of Kidney: A Case Report. Urol Case Rep 2017; 10:26-29. [PMID: 27896135 PMCID: PMC5122699 DOI: 10.1016/j.eucr.2016.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 10/19/2016] [Indexed: 11/06/2022] Open
Abstract
Renal cell carcinoma (RCC) is the most common malignancy of the kidney. It is not commonly form tumor thrombus in the ureter or renal pelvis. A 29-year-old woman presented with asymptomatic gross hematuria. Contrast CT study revealed a tumor suspected to be a Transitional Cell Carcinoma (TCC). However, tumor thrombus was found in the renal pelvis and ureter. We performed Nephroureterectomy, bladder cuff excision, and lymph node dissection, and the tumor was diagnosed histopathologically as RCC. We report a very rare case of thrombus-like tumor of renal cell carcinoma mimicking transitional cell carcinoma of kidney.
Collapse
Affiliation(s)
- Dyandra Parikesit
- Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta 10430, Indonesia
| | - Chaidir A. Mochtar
- Department of Urology, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta 10430, Indonesia
| | - Budiana Tanurahardja
- Department of Pathology Anatomy, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta 10430, Indonesia
| | - Sahat Matondang
- Department of Radiology, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta 10430, Indonesia
| | - Rainy Umbas
- Department of Urology, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta 10430, Indonesia
| | - Agus Rizal Hamid
- Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta 10430, Indonesia
| |
Collapse
|
45
|
Correlating Preoperative Imaging with Histologic Subtypes of Renal Cell Carcinoma and Common Mimickers. Curr Urol Rep 2016; 17:52. [PMID: 27154238 DOI: 10.1007/s11934-016-0606-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Renal cell carcinoma (RCC) consists of distinct subtypes that have unique pathologic and imaging features as well as specific cytogenetic and molecular characteristics. As the prognosis and therapeutic strategies may differ for each subtype, correlation of the preoperative imaging with the pathologic findings is of great clinical relevance. In addition, differentiation of RCC from benign entities is ideal in order to prevent overtreatment. However, a noninvasive diagnosis with imaging alone is not always straightforward due to the overlapping appearance of RCC with benign lesions such as fat-poor angiomyolipoma and oncocytoma. With new imaging modalities, there have been significant improvements in correlating preoperative imaging with pathologic characteristics. These new discoveries are able to aid in a more specific, noninvasive, diagnosis that in turn helps direct patient management.
Collapse
|
46
|
|
47
|
Kata SG, Zreik A, Ahmad S, Chłosta P, Aboumarzouk O. Concurrent bladder cancer in patients undergoing photodynamic diagnostic ureterorenoscopy: how many lesions do we miss under white light cystoscopy? Cent European J Urol 2016; 69:334-340. [PMID: 28127447 PMCID: PMC5260463 DOI: 10.5173/ceju.2016.896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 10/03/2016] [Accepted: 10/27/2016] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION There is an ongoing debate on panurothelial changes in the upper and lower urinary tract as multifocal presentation of urothelial cancer is well recognised. Concurrent bladder cancer impacts the outcome of the upper urinary tract urothelial cancer treatment, while its detection still relies on the white light cystoscopy. MATERIAL AND METHODS We retrospectively reviewed all patients who underwent photodynamic diagnostic ureterorenoscopy, choosing those who had synchronous bladder biopsies. Each patient received 20 mg/kg body weight of oral 5-Aminolevulinic acid around 3-4 hours before endoscopy. All procedures were performed by a single endourologist experienced in photodynamic diagnosis and flexible ureterorenoscopy. RESULTS Between July 2009 and June 2013, 69 patients underwent bladder biopsies at the time of photodynamic diagnostic endoscopic inspection of the upper urinary tract. In total, 43.5% (30/69) patients were found to have bladder lesions, of which 43.3% (13/30) were proven to be carcinoma in situ. White light inspection of the bladder missed bladder cancer in 16 (23.1%) patients, of which 12 were carcinoma in situ. There were 14 bladder cancer lesions missed under white light which were concomitant to the upper urinary tract urothelial cancer. Twelve (17.4%) patients developed minor complications relevant to the photosensitizer. CONCLUSIONS The study raises a concern about missing small bladder cancer/carcinoma in situ lesions on the initial diagnosis or in surveillance of the upper urinary tract urothelial cancer. Higher than previously reported, the rate of concomitant bladder cancer may suggest utilisation of photodynamic diagnosis to ensure the cancer free status of the bladder, but this needs to be ratified in a multi-institutional randomised trial.
Collapse
Affiliation(s)
- Sławomir G Kata
- Department of Urology, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | | | - Sarfraz Ahmad
- Department of Urology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - Piotr Chłosta
- Academic Urological Unit, Collegium Medicum, Jagielloński University, Cracow, Poland
| | | |
Collapse
|
48
|
Rippy SB, Gardner HL, Nguyen SM, Warry EE, Portela RA, Drost WT, Hostnik ET, Green EM, Chew DJ, Peng J, London CA. A pilot study of toceranib/vinblastine therapy for canine transitional cell carcinoma. BMC Vet Res 2016; 12:257. [PMID: 27855679 PMCID: PMC5114733 DOI: 10.1186/s12917-016-0882-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 11/08/2016] [Indexed: 02/06/2023] Open
Abstract
Background Effective therapies for transitional cell carcinoma (TCC) are limited, with objective response rates to most chemotherapeutic regimens below 20%. The purpose of this study was to investigate the biologic activity of combined toceranib phosphate and vinblastine chemotherapy for treatment of TCC. A secondary objective was to compare the utility of Computed Tomography (CT) and abdominal ultrasound (AUS) in tumor response assessments. Results Dogs with TCC received vinblastine at 1.6 mg/m2 every 2 weeks and toceranib at 2.5–2.75 mg/kg on Monday/Wednesday/Friday. Tumor monitoring was achieved through CT and AUS. Five patients completed the 16-week study. Based on AUS assessments, 3 dogs experienced biologic response to therapy including partial responses (PR, n = 2) and stable disease (SD, n = 1). Based on CT, 5 dogs experienced a biologic response (n = 2 PR, n = 3 SD). Both imaging modalities (ultrasound and CT) were found to provide repeatable measurements between operators, however agreement between operator measurements was greater when CT images were used to assess tumor size. Conclusions The combination of toceranib and vinblastine did not result in improved response rates. While agreement in tumor volume assessments between both AUS and CT were excellent between operators, this did not extend to assessment of tumor response. The higher rate of concordance between operators when assessing response to treatment with CT suggests that CT should be considered for future clinical trials involving canine bladder TCC to improve the accuracy and repeatability of tumor measurement. The data suggest that response to therapy as assessed by AUS or CT do not predict duration of clinical response.
Collapse
Affiliation(s)
| | - Heather L Gardner
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA
| | | | - Emma E Warry
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA
| | | | - William Tod Drost
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA
| | - Eric T Hostnik
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA
| | - Eric M Green
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA
| | - Dennis J Chew
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA
| | - Juan Peng
- Department of Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Cheryl A London
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA.
| |
Collapse
|
49
|
Abstract
Multiparametric MR imaging (mpMRI) combine different sequences that, properly tailored, can provide qualitative and quantitative information about the tumor microenvironment beyond traditional tumor size measures and/or morphologic assessments. This article focuses on mpMRI in the evaluation of urogenital tract malignancies by first reviewing technical aspects and then discussing its potential clinical role. This includes insight into histologic subtyping and grading of renal cell carcinoma and assessment of tumor response to targeted therapies. The clinical utility of mpMRI in the staging and grading of ureteral and bladder tumors is presented. Finally, the evolving role of mpMRI in prostate cancer is discussed.
Collapse
|
50
|
Wong KY, Chaudhry M, Hamm R, Belfield J. Radiological investigation of haematuria in 2016. JOURNAL OF CLINICAL UROLOGY 2016. [DOI: 10.1177/2051415816659406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Kee Y Wong
- Department of Urology, the Royal Liverpool and Broadgreen University Hospital NHS Trust, UK
| | - Mubeen Chaudhry
- Department of Radiology, the Royal Liverpool and Broadgreen University Hospital NHS Trust, UK
| | - Rebecca Hamm
- Department of Urology, the Royal Liverpool and Broadgreen University Hospital NHS Trust, UK
| | - Jane Belfield
- Department of Radiology, the Royal Liverpool and Broadgreen University Hospital NHS Trust, UK
| |
Collapse
|