Skip to main content
Top
Published in: Abdominal Radiology 6/2016

01-06-2016 | Invited Article

CT urography in evaluation of urothelial tumors of the kidney

Authors: Elaine M. Caoili, Richard H. Cohan

Published in: Abdominal Radiology | Issue 6/2016

Login to get access

Excerpt

After a long period of stability, imaging of the urinary tract and urothelium has changed dramatically in the past several decades. Excretory urography (EU) was widely used from the 1950s to the 1980s, as EU was able to show the renal collecting systems and ureters non-invasively, unlike retrograde pyelography. EU also provided a cursory evaluation of the renal parenchyma, an evaluation which improved with the addition of nephrotomography. With the introduction of CT, the role of EU began to decline by the early 1980s. CT was quickly identified as being superior to EU for detecting and characterizing renal masses [13] and in detecting urolithiasis [35]. With continuing advances in CT technology, CT is now able to provide an assessment of the urinary tract and urothelium using CT urography (CTU). Multidetector CT technology allows for faster imaging with thin section volume data creating high spatial resolution images. Multidetector CTU can offer a comprehensive CT evaluation of the kidneys and urinary tract. …
Literature
1.
go back to reference Warshauer DM, McCarthy SM, Street L, et al. (1988) Detection of renal masses: sensitivities and specificities of excretory urography/linear tomography, US, and CT. Radiology 169:363–365CrossRefPubMed Warshauer DM, McCarthy SM, Street L, et al. (1988) Detection of renal masses: sensitivities and specificities of excretory urography/linear tomography, US, and CT. Radiology 169:363–365CrossRefPubMed
2.
go back to reference Fielding JR, Steele G, Fox A, Heller H, Laughlin KR (1997) Spiral computerized tomography in the evaluation of acute flank pain: a replacement for excretory urography. J Urol 157:2171–2173CrossRef Fielding JR, Steele G, Fox A, Heller H, Laughlin KR (1997) Spiral computerized tomography in the evaluation of acute flank pain: a replacement for excretory urography. J Urol 157:2171–2173CrossRef
3.
go back to reference Sourtzis S, Thibeau JF, Damry N, et al. (1999) Radiologic investigation of renal colic: unenhanced helical CT compared with excretory urography. AJR 172:1491–1494CrossRefPubMed Sourtzis S, Thibeau JF, Damry N, et al. (1999) Radiologic investigation of renal colic: unenhanced helical CT compared with excretory urography. AJR 172:1491–1494CrossRefPubMed
4.
go back to reference Dalrymple NC, Verga M, Anderson KR, et al. (1998) The value of unenhanced helical computerized tomography in the management of acute flank pain. J Urol 159:735–740CrossRefPubMed Dalrymple NC, Verga M, Anderson KR, et al. (1998) The value of unenhanced helical computerized tomography in the management of acute flank pain. J Urol 159:735–740CrossRefPubMed
5.
go back to reference Smith RC, Verga M, McCarthy S, Rosenfield AT (1996) Diagnosis of acute flank pain: value of unenhanced helical CT. AJR 166:97–101CrossRefPubMed Smith RC, Verga M, McCarthy S, Rosenfield AT (1996) Diagnosis of acute flank pain: value of unenhanced helical CT. AJR 166:97–101CrossRefPubMed
6.
go back to reference Caoili EM, Cohan RH, Korobkin M, et al. (2002) Urinary tract abnormalities: initial experience with multi-detector row CT urography. Radiology 222:353–360CrossRefPubMed Caoili EM, Cohan RH, Korobkin M, et al. (2002) Urinary tract abnormalities: initial experience with multi-detector row CT urography. Radiology 222:353–360CrossRefPubMed
7.
go back to reference Caoili EM, Cohan RH, Inampudi P, et al. (2005) MDCT urography of upper tract urothelial neoplasms. AJR 184:1873–1881CrossRefPubMed Caoili EM, Cohan RH, Inampudi P, et al. (2005) MDCT urography of upper tract urothelial neoplasms. AJR 184:1873–1881CrossRefPubMed
8.
go back to reference Chow LC, Sommer FG (2001) Multidetector CT urography with abdominal compression and three-dimensional reconstruction. AJR 177:849–855CrossRefPubMed Chow LC, Sommer FG (2001) Multidetector CT urography with abdominal compression and three-dimensional reconstruction. AJR 177:849–855CrossRefPubMed
10.
go back to reference Davis R, Jones JS, Barocas DA, et al. (2012) Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults. AUA guidelines. J Urol 188:2473–2481CrossRefPubMed Davis R, Jones JS, Barocas DA, et al. (2012) Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults. AUA guidelines. J Urol 188:2473–2481CrossRefPubMed
11.
go back to reference Maheshwari E, O’Malley ME, Ghai S, Staunton M, Massey C (2010) Split-bolus MDCT urography: upper tract opacification and performance for upper tract tumors in patients with hematuria. AJR 194:453–458CrossRefPubMed Maheshwari E, O’Malley ME, Ghai S, Staunton M, Massey C (2010) Split-bolus MDCT urography: upper tract opacification and performance for upper tract tumors in patients with hematuria. AJR 194:453–458CrossRefPubMed
12.
go back to reference Chow LC, Kwan SW, Olcott EW, Sommer G (2007) Split-bolus MDCT urography with synchronous nephrographic and excretory phase enhancement. AJR 189:314–322CrossRefPubMed Chow LC, Kwan SW, Olcott EW, Sommer G (2007) Split-bolus MDCT urography with synchronous nephrographic and excretory phase enhancement. AJR 189:314–322CrossRefPubMed
13.
go back to reference Kekelidze M, Dwarkasing R, Dijkshoorn ML, et al. (2010) Kidney and urinary tract imaging: triple-bolus multidetector CT urography as a one-stop shop-protocol design, opacification, and image quality analysis. Radiology 255:508–516CrossRefPubMed Kekelidze M, Dwarkasing R, Dijkshoorn ML, et al. (2010) Kidney and urinary tract imaging: triple-bolus multidetector CT urography as a one-stop shop-protocol design, opacification, and image quality analysis. Radiology 255:508–516CrossRefPubMed
14.
go back to reference Szolar DH, Tillich M, Preidler KW (2010) Multi-detector CT urography: effect of oral hydration and contrast medium volume on renal parenchymal enhancement and urinary tract opacification–a quantitative and qualitative analysis. Eur Radiol 20:2146–2152CrossRefPubMed Szolar DH, Tillich M, Preidler KW (2010) Multi-detector CT urography: effect of oral hydration and contrast medium volume on renal parenchymal enhancement and urinary tract opacification–a quantitative and qualitative analysis. Eur Radiol 20:2146–2152CrossRefPubMed
15.
go back to reference McTavish JD, Jinzaki M, Zou KH, Nawfel RD, Silverman SG (2002) Multi-detector row CT urography: comparison of strategies for depicting the normal urinary collecting system. Radiology 225:783–790CrossRefPubMed McTavish JD, Jinzaki M, Zou KH, Nawfel RD, Silverman SG (2002) Multi-detector row CT urography: comparison of strategies for depicting the normal urinary collecting system. Radiology 225:783–790CrossRefPubMed
16.
go back to reference Caoili EM, Inampudi P, Cohan RH (2005) Optimization of multi-detector row CT urography: effect of compression, saline administration, and prolongation of acquisition delay. Radiology 235:116–123CrossRefPubMed Caoili EM, Inampudi P, Cohan RH (2005) Optimization of multi-detector row CT urography: effect of compression, saline administration, and prolongation of acquisition delay. Radiology 235:116–123CrossRefPubMed
17.
go back to reference Sudakoff GS, Dunn HP, Hellman RS, et al. (2006) Opacification of the genitourinary collecting system during MDCT urography with enhanced CT digital radiography: nonsaline versus saline bolus. AJR 186:122–129CrossRefPubMed Sudakoff GS, Dunn HP, Hellman RS, et al. (2006) Opacification of the genitourinary collecting system during MDCT urography with enhanced CT digital radiography: nonsaline versus saline bolus. AJR 186:122–129CrossRefPubMed
18.
go back to reference Silverman SG, Akbar SA, Mortele KJ, et al. (2006) Multi-detector row CT urography of normal urinary collecting system: furosemide versus normal saline as adjunct to contrast medium. Radiology 240:749–755CrossRefPubMed Silverman SG, Akbar SA, Mortele KJ, et al. (2006) Multi-detector row CT urography of normal urinary collecting system: furosemide versus normal saline as adjunct to contrast medium. Radiology 240:749–755CrossRefPubMed
19.
go back to reference Kemper J, Regier M, Stork A, Adam G, Nolte-Ernsting C (2006) Improved visualization of the urinary tract in multidetector CT urography (MDCTU): analysis of individual acquisition delay and opacification using furosemide and low-dose test images. J Comput Assist Tomogr 30:751–757CrossRefPubMed Kemper J, Regier M, Stork A, Adam G, Nolte-Ernsting C (2006) Improved visualization of the urinary tract in multidetector CT urography (MDCTU): analysis of individual acquisition delay and opacification using furosemide and low-dose test images. J Comput Assist Tomogr 30:751–757CrossRefPubMed
20.
go back to reference Sanyal R, Deshmukh A, Singh Sheorain V, Taori K (2007) CT urography: a comparison of strategies for upper urinary tract opacification. Eur Radiol 17:1262–1266CrossRefPubMed Sanyal R, Deshmukh A, Singh Sheorain V, Taori K (2007) CT urography: a comparison of strategies for upper urinary tract opacification. Eur Radiol 17:1262–1266CrossRefPubMed
21.
go back to reference Cohen SM, Johansson SL (1982) Epidemiology and etiology of bladder cancer. Urology 19:472–477CrossRef Cohen SM, Johansson SL (1982) Epidemiology and etiology of bladder cancer. Urology 19:472–477CrossRef
22.
go back to reference Wong You-Cheong JJ, Wagner BJ, Davis CJ (1998) Transitional cell carcinoma of the urinary tract: radiologic-pathologic correlation. Radiographics 18:123–142CrossRefPubMed Wong You-Cheong JJ, Wagner BJ, Davis CJ (1998) Transitional cell carcinoma of the urinary tract: radiologic-pathologic correlation. Radiographics 18:123–142CrossRefPubMed
23.
go back to reference Jenal A, Siegel R, Xu J (2010) Cancer statistics, 2010. CA Cancer J Clin 60:277–300CrossRef Jenal A, Siegel R, Xu J (2010) Cancer statistics, 2010. CA Cancer J Clin 60:277–300CrossRef
24.
go back to reference Hall MC, Womack S, Sagalowshy AI (1998) Prognostic factors, recurrence and survival in transitional cell carcinoma of the upper urinary tract: a 30 year experience in 252 patients. Urology 52:594–601CrossRefPubMed Hall MC, Womack S, Sagalowshy AI (1998) Prognostic factors, recurrence and survival in transitional cell carcinoma of the upper urinary tract: a 30 year experience in 252 patients. Urology 52:594–601CrossRefPubMed
25.
go back to reference Kirkali Z, Tuzel E (2003) Transitional cell carcinoma of the ureter and renal pelvis. Crit Rev Oncol Hematol 47:155–169CrossRefPubMed Kirkali Z, Tuzel E (2003) Transitional cell carcinoma of the ureter and renal pelvis. Crit Rev Oncol Hematol 47:155–169CrossRefPubMed
26.
go back to reference Melamed MR, Reuter VE (1993) Pathology and staging of urothelial tumors of the kidney and ureter. Urol Clin N Am 29:333–347 Melamed MR, Reuter VE (1993) Pathology and staging of urothelial tumors of the kidney and ureter. Urol Clin N Am 29:333–347
27.
go back to reference Guinan P, Vogelzang NJ, Randazzo R, et al. (1992) Renal pelvic cancer: a review of 611 patients treated in Illinois 1975-1985. Cancer Incidence and End Results Committee. Urology 40:393–399CrossRefPubMed Guinan P, Vogelzang NJ, Randazzo R, et al. (1992) Renal pelvic cancer: a review of 611 patients treated in Illinois 1975-1985. Cancer Incidence and End Results Committee. Urology 40:393–399CrossRefPubMed
28.
go back to reference Herr HW, Cookson MS, Soloway SM (1996) Upper tract tumors in patients with primary bladder cancer followed for 15 years. J Urol 156:1286–1287CrossRefPubMed Herr HW, Cookson MS, Soloway SM (1996) Upper tract tumors in patients with primary bladder cancer followed for 15 years. J Urol 156:1286–1287CrossRefPubMed
29.
go back to reference Rabbani F, Perrotti M, Russo P (2001) Upper tract tumors after an initial diagnosis of bladder cancer: argument for long-term surveillance. J Clin Oncol 19:94–100PubMed Rabbani F, Perrotti M, Russo P (2001) Upper tract tumors after an initial diagnosis of bladder cancer: argument for long-term surveillance. J Clin Oncol 19:94–100PubMed
30.
go back to reference Cowan NC, Turney BW, Taylor NJ, McCarthy CL, Crew JP (2007) Multidetector computed tomography urography for diagnosing urinary tract urothelial carcinoma. BJU Intern 99:1363–1370CrossRef Cowan NC, Turney BW, Taylor NJ, McCarthy CL, Crew JP (2007) Multidetector computed tomography urography for diagnosing urinary tract urothelial carcinoma. BJU Intern 99:1363–1370CrossRef
31.
go back to reference Sudakoff GS, Dunn DP, Guralnick ML, et al. (2008) Multidetector computerized tomography urography as the primary imaging modality for detecting urinary tract neoplasms in patients with asymptomatic hematuria. J Urol 179:862–867CrossRefPubMed Sudakoff GS, Dunn DP, Guralnick ML, et al. (2008) Multidetector computerized tomography urography as the primary imaging modality for detecting urinary tract neoplasms in patients with asymptomatic hematuria. J Urol 179:862–867CrossRefPubMed
32.
go back to reference Mueller-Lisse UG, Mueller-Lisse UL, Hinterberger J, et al. (2007) Multidetector-row computed tomography (MDCT) in patients with a history of previous urothelial cancer or painless macroscopic haematuria. Eur Radiol 17:2794–2803CrossRefPubMed Mueller-Lisse UG, Mueller-Lisse UL, Hinterberger J, et al. (2007) Multidetector-row computed tomography (MDCT) in patients with a history of previous urothelial cancer or painless macroscopic haematuria. Eur Radiol 17:2794–2803CrossRefPubMed
33.
go back to reference Chlapoutakis K, Theocharopoulos N, Yarmenitis S, Damilakis J (2010) Performance of computed tomographic urography in the diagnosis of upper urinary tract urothelial carcinoma, in patients presenting with hematuria: systematic review and meta-analysis. Eur J Radiol 73:334–338CrossRefPubMed Chlapoutakis K, Theocharopoulos N, Yarmenitis S, Damilakis J (2010) Performance of computed tomographic urography in the diagnosis of upper urinary tract urothelial carcinoma, in patients presenting with hematuria: systematic review and meta-analysis. Eur J Radiol 73:334–338CrossRefPubMed
34.
go back to reference Jinzaki M, Matsumoto K, Kikuchi E, et al. (2011) Comparison of CT urography and excretory urography in the detection and localization of urothelial carcinoma of the upper urinary tract. AJR 196:1109CrossRef Jinzaki M, Matsumoto K, Kikuchi E, et al. (2011) Comparison of CT urography and excretory urography in the detection and localization of urothelial carcinoma of the upper urinary tract. AJR 196:1109CrossRef
35.
go back to reference McCarthy CL, Cowan NC (2002) Multi-detector CT urography (MD-CTU) for urothelial imaging. Radiology 225:237 McCarthy CL, Cowan NC (2002) Multi-detector CT urography (MD-CTU) for urothelial imaging. Radiology 225:237
36.
go back to reference Leder RA, Dunnick NR (1990) Transitional cell carcinoma of the pelvicalices and ureter. AJR 155:713–722CrossRefPubMed Leder RA, Dunnick NR (1990) Transitional cell carcinoma of the pelvicalices and ureter. AJR 155:713–722CrossRefPubMed
37.
go back to reference Metser U, Goldstein MA, Chawla TP, et al. (2012) Detection of urothelial tumors: comparison of urothelial phase with excretory phase CT urography—a prospective study. Radiology 264:110–118CrossRefPubMed Metser U, Goldstein MA, Chawla TP, et al. (2012) Detection of urothelial tumors: comparison of urothelial phase with excretory phase CT urography—a prospective study. Radiology 264:110–118CrossRefPubMed
38.
go back to reference Takeuchi M, Konrad AJ, Kawashima A, Boorjian SA, Takahashi N (2015) CT urography for diagnosis of upper urinary tract urothelial carcinoma; are both nephrographic and excretory phases necessary? AJR 205:W320–W327CrossRefPubMed Takeuchi M, Konrad AJ, Kawashima A, Boorjian SA, Takahashi N (2015) CT urography for diagnosis of upper urinary tract urothelial carcinoma; are both nephrographic and excretory phases necessary? AJR 205:W320–W327CrossRefPubMed
39.
go back to reference Vikran R, Sandler CM, Ng CS (2009) Imaging and staging of transitional cell carcinoma: Part 2, upper urinary tract. AJR 33:377–396 Vikran R, Sandler CM, Ng CS (2009) Imaging and staging of transitional cell carcinoma: Part 2, upper urinary tract. AJR 33:377–396
40.
go back to reference Fritz GA, Schoellnast H, Deutschmann HA, Quehenberger F, Tillich M (2006) Multiphasic multidetector CT (MDCT) in detection and staging of transitional cell carcinomas of the upper urinary tract. Eur Radiol 16:1244–1252CrossRefPubMed Fritz GA, Schoellnast H, Deutschmann HA, Quehenberger F, Tillich M (2006) Multiphasic multidetector CT (MDCT) in detection and staging of transitional cell carcinomas of the upper urinary tract. Eur Radiol 16:1244–1252CrossRefPubMed
41.
go back to reference Honda Y, Goto K, Sentani K, et al. (2015) T Categorization of urothelial carcinomas of the ureter with CT: preliminary study of new diagnostic criteria proposed for differentiating T2 or lower from T3 higher. AJR 204:792–797CrossRefPubMed Honda Y, Goto K, Sentani K, et al. (2015) T Categorization of urothelial carcinomas of the ureter with CT: preliminary study of new diagnostic criteria proposed for differentiating T2 or lower from T3 higher. AJR 204:792–797CrossRefPubMed
42.
go back to reference Sadow CA, Wheeler SC, Kim J, Ohno-Machado L, Silverman SG (2010) Positive predictive value of CT urography in the evaluation of upper tract urothelial cancer. AJR 195:W337–W343CrossRefPubMed Sadow CA, Wheeler SC, Kim J, Ohno-Machado L, Silverman SG (2010) Positive predictive value of CT urography in the evaluation of upper tract urothelial cancer. AJR 195:W337–W343CrossRefPubMed
Metadata
Title
CT urography in evaluation of urothelial tumors of the kidney
Authors
Elaine M. Caoili
Richard H. Cohan
Publication date
01-06-2016
Publisher
Springer US
Published in
Abdominal Radiology / Issue 6/2016
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-016-0695-x

Other articles of this Issue 6/2016

Abdominal Radiology 6/2016 Go to the issue

Classics in Abdominal Imaging

The “beak” sign

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.