Upper urinary tract tumors: how does the contrast enhancement measured in a split-bolus CTU correlate to histological staging?
Research output: Contribution to journal › Journal article › Research › peer-review
BACKGROUND: Computed tomography urography (CTU) is used widely in the work-up of patients with symptoms of urinary tract lesions. Preoperative knowledge of whether a tumor is invasive or non-invasive is important for the choice of surgery. So far there are no studies about the distinction of invasive and non-invasive tumors in ureter and renal pelvis based on the enhancement measured with Hounsfield Units.
PURPOSE: To examine the value of CTU using split-bolus technique to distinguish non-invasive from invasive urothelial carcinomas in the upper urinary tract.
MATERIAL AND METHODS: Patients who underwent nephroureterectomy between 2006 and 2011 and who had split-bolus CTU prior to surgery were included. The images were available electronically. The attenuation values before and after administration of iodine-based contrast media were measured. The radiology, patient, and pathology records were reviewed.
RESULTS: Of the 158 patients who underwent unilateral nephroureterectomy 69 fulfilled the inclusion criteria. Histopathological examination revealed 31 patients with non-invasive and 38 with invasive urothelial carcinoma. Neither absolute attenuation nor change in attenuation values obtained at CTU could distinguish between invasive and non-invasive lesions. No patients had a CTU within the last year before the examination that resulted in surgery.
CONCLUSION: A split-bolus CTU cannot distinguish between invasive and non-invasive urothelial tumors in the upper urinary tract, but the examination is useful to diagnose a tumor in the renal pelvis and the ureter.
Original language | English |
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Journal | Acta Radiologica |
Volume | 55 |
Issue number | 6 |
Pages (from-to) | 761-768 |
Number of pages | 8 |
ISSN | 0284-1851 |
DOIs | |
Publication status | Published - Jul 2014 |
- Adult, Aged, Aged, 80 and over, Contrast Media, Diagnosis, Differential, Female, Humans, Image Processing, Computer-Assisted, Iopamidol, Kidney Pelvis, Male, Middle Aged, Neoplasm Grading, Neoplasm Staging, Observer Variation, Radiographic Image Enhancement, Reproducibility of Results, Tomography, X-Ray Computed, Ureter, Ureteral Neoplasms, Urologic Neoplasms
Research areas
ID: 138547165