CT-Urographie bei Frauen mit primären oder rezidivierenden Beckentumoren

Abstract

Malignant tumors of the female pelvis account for 12-13% of newly diagnosed solid neoplasms among women in the USA and Germany. German guidelines advocate diagnostic imaging for local recurrence and metastasis while there are no recommendations for primary tumors. As excretory urography has been replaced by the excretory phase of computed tomography urography (CTU) in many institutions, two independent observers retrospectively evaluated CTUs of primary or recurrent female pelvic tumors to rule out associations between CTU findings and subsequent urologic measures. Among 31 CTUs of 27 women (age 29-84 years, mean 57 years) with 15 primary and 13 recurrent tumors, 83-100% of unremarkable proximal, middle and distal ureter segments were completely delineated in the excretory phase (delay 6-29 min, mean 16 min). The most common pathological findings included distal ureter obstruction (n=19, 61%), bladder compression (n=13, 42%) and bladder invasion (n=8, 26%). Out of 20 pathologically altered urinary tracts 8 were subsequently subjected to urologic measures (2-tailed Fisher exact test, p=0.0215) but none of the 10 unremarkable urinary tracts were treated. It appears that CTU is a sensible pre-therapeutic test for the urinary tract for primary and recurrent female pelvic tumors.

Catheter-based intraluminal optical coherence tomography of the normal human upper urinary tract in vivo: proof of concept and comparison with an ex-vivo porcine model

“…Also, in patients with UC affecting the bladder and at least one UUT, or in panurothelial disease, therapeutic concepts try to be as radical as necessary while preserving as much urinary tract function as possible [26,27]. In addition, extra-urinary tumors may compress or invade the UUT and become the subject of pre-therapeutic imaging [28].…”