CT of the urinary tract revisited

Tsili, Athina C.; Varkarakis, Ioannis; Pasoglou, Vassiliki; Anagnostou, Nikoletta; Argyropoulou, Maria I.

doi:10.1016/j.ejrad.2023.110717

Cited by 9 publications

(4 citation statements)

References 94 publications

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“…Computed tomography (CT) is commonly used for the diagnosis and staging of bladder cancer, but the results are usually based on the experience of radiologist with low interobserver consistency 7 , 8 . Radiomics, a novel quantitative image analysis method, can provide a noninvasive tool for identifying the biological behavior of tumors by automatically extracting and analyzing high-throughput quantitative data from medical images (e.g.…”

Section: Introductionmentioning

confidence: 99%

A CT-based deep learning model predicts overall survival in patients with muscle invasive bladder cancer after radical cystectomy: a multicenter retrospective cohort study

Wei,

Xv,

Liu

et al. 2024

International Journal of Surgery

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Background: Muscle invasive bladder cancer (MIBC) has a poor prognosis even after radical cystectomy (RC). Postoperative survival stratification based on radiomics and deep learning algorithms may be useful for treatment decision-making and follow-up management. This study was aimed to develop and validate a deep learning (DL) model based on preoperative CT for predicting post-cystectomy overall survival in patients with MIBC. Methods: MIBC patients who underwent RC were retrospectively included from four centers, and divided into the training, internal validation and external validation sets. A deep learning model incorporated the convolutional block attention module (CBAM) was built for predicting overall survival using preoperative CT images. We assessed the prognostic accuracy of the DL model and compared it with classic handcrafted radiomics model and clinical model. Then, a deep learning radiomics nomogram (DLRN) was developed by combining clinicopathological factors, radiomics score (Rad-score) and deep learning score (DL-score). Model performance was assessed by C-index, KM curve, and time-dependent ROC curve. Results: A total of 405 patients with MIBC were included in this study. The DL-score achieved a much higher C-index than Rad-score and clinical model (0.690 vs. 0.652 vs. 0.618 in the internal validation set, and 0.658 vs. 0.601 vs. 0.610 in the external validation set). After adjusting for clinicopathologic variables, the DL-score was identified as a significantly independent risk factor for OS by the multivariate Cox regression analysis in all sets (all P<0.01). The DLRN further improved the performance, with a C-index of 0.713 (95%CI: 0.627-0.798) in the internal validation set and 0.685 (95%CI: 0.586-0.765) in external validation set, respectively. Conclusions: A DL model based on preoperative CT can predict survival outcome of patients with MIBC, which may help in risk stratification and guide treatment decision-making and follow-up management.

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Section: Introductionmentioning

confidence: 99%

A CT-based deep learning model predicts overall survival in patients with muscle invasive bladder cancer after radical cystectomy: a multicenter retrospective cohort study

Wei,

Xv,

Liu

et al. 2024

International Journal of Surgery

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“…It provides crucial information about the tumor location, invasion depth, and its relationship with the surrounding structures. Enhanced scanning further aids in understanding the tumor’s blood supply and confirming its nature as a primary option ( 4 ). The main CTU appearances of UTUCs include mild enhancement of soft tissue lesions, renal pelvic filling defects, diffuse thickening of the renal pelvic wall, the stipple sign, or phantom calyx ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Atypical presentations of UTUC: a case report of three patients

Guo,

Bai,

Tuoheti

et al. 2024

Front. Oncol.

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BackgroundUpper tract urothelial carcinoma (UTUC) is a rare clinical condition primarily characterized by symptoms such as gross or microscopic hematuria, flank pain, and renal colic. Although computed tomography urography (CTU) is currently the most accurate imaging modality for diagnosis, atypical presentations and physical examination findings can sometimes obscure lesions, posing diagnostic challenges.Case presentationIn this report, three patients exhibited atypical symptoms, sharing a common complaint of flank pain. Notably, the first patient, who had recently undergone laparoscopic right duplex nephrectomy, presented with microscopic hematuria, whereas the other two did not show any gross or microscopic hematuria. Computed tomography urography revealed hydronephrosis and infection without significant renal pelvic space-occupying lesions, with persistently elevated white blood cell (WBC) counts, but no fever. These atypical clinical presentations confounded clinicians, delaying the diagnosis of upper tract urothelial carcinoma until postoperative pathological examination for the first two patients and resulting in advanced-stage diagnosis for the third patient. Postoperative pathology confirmed high-grade invasive upper tract urothelial carcinoma in all three patients.ConclusionUpper tract urothelial carcinoma can manifest atypically without hematuria and may be challenging to visualize on computed tomography urography, potentially leading to misdiagnosis. Therefore, clinicians should maintain a high level of suspicion for malignant tumors when patients exhibit hydronephrosis, infection on imaging, and persistently elevated white blood cell counts without fever, even in the absence of typical signs of upper urothelial carcinoma on computed tomography urography.

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“…Urethral parameatal cysts are usually an incidental finding on physical examination (Tsili et al, 2023). They are mostly asymptomatic, although sometimes accompanied by several symptoms, including dysuria, frequency, distortion of urine flow, or urinary retention (Partin et al, 2021;Yu et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Parameatal Urethral Cyst in a 20-Year-Old Male Patient: A Case Report

Yofita Olga Wemona,

Kurnia Darma,

Ishaq

et al. 2024

ijsh

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The parameatal urethral cyst is a rare anomaly and appears as a small blister in proximity to the urethral meatus. These cysts may result from occlusion of paraurethral ducts or, in other cases, from faulty preputial separation from the glans along the coronal sulcus. A 20-year-old male patient came to our outpatient clinic at dr. M. Soewandhie General Hospital Surabaya with a cystic lesion on the right side of the external urethral meatus. The patient only found out about his situation one year ago, and he did not experience any complaints except a branched urination. On physical examination, an 8 mm cystic lesion was found on the right side of the external urethral meatus. The patient consented to complete surgical excision of the cyst. The procedure was performed under regional anesthesia. The cyst was completely resected from the surrounding tissues. One month after surgery, there is no post-operative pain and good urine flow, and the patient is also satisfied with the post-operative condition. Histologic examination shows pieces of tissue in the form of polypoid lined with squamous epithelium underneath, stroma of fibrous tissue with proliferation of blood vessels and some inflammatory cells of lymphocytes in between. There are no signs of malignancy. Parameatal urethral cyst is an abnormal and rare case, usually asymptomatic. However, sometimes dysuria, urinary retention, branching urine, and cosmetic problems are the reasons that cause patients to seek a doctor's help. It can be diagnosed just on physical examination and can be cured by complete excision.

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CT of the urinary tract revisited

Cited by 9 publications

References 94 publications

A CT-based deep learning model predicts overall survival in patients with muscle invasive bladder cancer after radical cystectomy: a multicenter retrospective cohort study

A CT-based deep learning model predicts overall survival in patients with muscle invasive bladder cancer after radical cystectomy: a multicenter retrospective cohort study

Atypical presentations of UTUC: a case report of three patients

Parameatal Urethral Cyst in a 20-Year-Old Male Patient: A Case Report

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