Upper urinary tract tumors: how does the contrast enhancement measured in a split-bolus CTU correlate to histological staging?
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Upper urinary tract tumors : how does the contrast enhancement measured in a split-bolus CTU correlate to histological staging? / Gandrup, Karen L; Nordling, Jørgen; Balslev, Ingegerd; Thomsen, Henrik S.
In: Acta Radiologica, Vol. 55, No. 6, 07.2014, p. 761-768.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Upper urinary tract tumors
T2 - how does the contrast enhancement measured in a split-bolus CTU correlate to histological staging?
AU - Gandrup, Karen L
AU - Nordling, Jørgen
AU - Balslev, Ingegerd
AU - Thomsen, Henrik S
N1 - © The Foundation Acta Radiologica 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
PY - 2014/7
Y1 - 2014/7
N2 - 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.
AB - 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.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Contrast Media
KW - Diagnosis, Differential
KW - Female
KW - Humans
KW - Image Processing, Computer-Assisted
KW - Iopamidol
KW - Kidney Pelvis
KW - Male
KW - Middle Aged
KW - Neoplasm Grading
KW - Neoplasm Staging
KW - Observer Variation
KW - Radiographic Image Enhancement
KW - Reproducibility of Results
KW - Tomography, X-Ray Computed
KW - Ureter
KW - Ureteral Neoplasms
KW - Urologic Neoplasms
U2 - 10.1177/0284185113505278
DO - 10.1177/0284185113505278
M3 - Journal article
C2 - 24056890
VL - 55
SP - 761
EP - 768
JO - Acta Radiologica - Series Diagnosis
JF - Acta Radiologica - Series Diagnosis
SN - 0365-5954
IS - 6
ER -
ID: 138547165