Multidetector Computerized Tomography Urography is More Accurate Than Excretory Urography for Diagnosing Transitional Cell Carcinoma of the Upper Urinary Tract in Adults With Hematuria

Wang, Li-Jen; Wong, Yon-Cheong; Huang, Chung‐Cheng; Wu, Cheng‐Hsien; Hung, Sheng-Che; Chen, Huan‐Wu

doi:10.1016/j.juro.2009.08.144

Cited by 96 publications

(53 citation statements)

References 20 publications

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“…Some guidelines suggest CTU for visible haematuria and not for non-visible haematuria unless there is high suspicion from baseline investigations [14], and this may be an appropriate economic practice. However, there will be a small number of urothelial lesions missed by this approach, given that CTU has a diagnostic superiority to the alternative investigations for haematuria [1,2]. Our diagnostic yield of urological malignancy was similar to that of previous studies [15,16], although these used intravenous urography and not CT.…”

Section: Discussionsupporting

confidence: 65%

“…It is difficult, however, to quantify the cost of the early identification of a treatable asymptomatic condition such as an aneurysm or adrenal malignancy. The cost incurred per patient is also relatively low when compared with the CT urogram itself and it is unlikely that the use of CTU will decrease owing to its superiority over IVU in detecting upper tract urothelial pathology [1][2][3].…”

Section: Discussionmentioning

confidence: 99%

“…Previously, intravenous urography (IVU) was the primary imaging modality for the upper urinary tract. However, CTU has been shown to be more accurate at identifying upper tract urothelial pathology [1][2][3]. It also has the advantage of providing accurate staging for newly diagnosed tumours of the urinary tract and, in particular, may provide valuable staging information prior to an endoscopic resection in bladder cancer.…”

mentioning

confidence: 99%

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The economic implications of unsuspected findings from CT urography performed for haematuria

Bromage

Liew²,

Moore³

et al. 2012

BJR

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Objectives: We set out to determine the prevalence of unsuspected findings from CT urography (CTU) performed for haematuria and to evaluate the economic implications associated with the subsequent management of these findings. Methods: We analysed the results of 778 consecutive CTU scans performed in a haematuria clinic between 2008 and 2010. We excluded cases where diagnosis of an abnormality had been made prior to CTU. Costs incurred during the follow-up of unsuspected findings were calculated following guidance set out in the NHS Costing Manual 2009/10. Results: 778 CTU scans were performed for patients attending a haematuria clinic from 2008 to 2010. 455 men and 323 women underwent CTU scan; they had a median age of 62 years. 56% of scans were found to have unexpected extra-urinary findings (587 abnormalities in 439 scans). Common findings included diverticular disease (138, 17.7%), adrenal masses [85, 10.9%; 40 (5.1%) of which were indeterminate], lung abnormalities (67, 8.6%), gall bladders containing calculi (44, 5.7%), adnexal cysts (25, 7.7% of women) and aortic aneurysms (18, 2.3%). These findings led to a total of 136 outpatient appointments, 88 radiological investigations and 11 procedures (4 of which were major). The overall cost incurred was £47 366, or £60 per patient. Conclusion: CTU is associated with a high rate of unsuspected findings. There is an economic implication to performing CT scanning in this setting, in which further unanticipated investigation and treatment cost is approximately £60 per patient.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The economic implications of unsuspected findings from CT urography performed for haematuria

Bromage

Liew²,

Moore³

et al. 2012

BJR

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“…Por tanto, la urografía por tomografía computerizada multidetector (UTCMD) se ha convertido en el gold estandar de las exploraciones radiológicas en el diagnóstico y seguimiento de este tipo de tumores, reemplazando a la urografía intravenosa (12,13,14).…”

Section: Discussionunclassified

Descriptive analysis of a series of 32 upper urinary tract tumors in a second level hospital

et al. 2014

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Análisis descriptivo de una serie de 32 tumores del tracto urinario superior en un hospital de segundo nivel ResumenIntroducción: El objetivo del estudio es analizar, basándonos en los pacientes tratados en nuestro servicio de tumores del tracto urinario superior, las características epidemiológicas y clínicas así como las variables que han influido en la evolución y mortalidad de estos pacientes. Materiales y Métodos: Se analizaron retrospectivamente 32 pacientes diagnosticados de tumores del tracto urinario superior en el Hospital comarcal Santa Ana de Motril (Granada), en el periodo comprendido entre enero del 2003 y diciembre del 2013. Resultados: La edad media fue de 72,25 años. El 75% eran hombres y el 25% mujeres. El 71.9% eran hipertensos, el 46.9% fumadores. El 18.8% presentaba un tumor vesical en el momento del diagnóstico. El 90.6% debutó con hematuria. El 53.1% se localizó en el lado derecho y el 43.8% en el izquierdo. El 25% se desarrollaron en los cálices, el 46.8% en la pelvis renal y el 50% a nivel ureteral. El estadio anatomopatológico al diagnóstico fue: 6.3% Ta, 25% T1, 28.1% T2, 37.5% T3 y 3.1% T4. El 21.9% eran grado I, el 34.4% grado II y el 43.8% grado III. No se observó recidiva tumoral en ningún paciente, siendo la mortalidad cáncer -específica del 0%. En 8 pacientes se diagnosticó un tumor vesical durante su seguimiento. La media de estancia hospitalaria fue de 7 días. Conclusiones: A pesar de ser una casuística limitada los resultados obtenidos son satisfactorios independientemente de la técnica quirúrgica empleada, al ser la supervivencia libre de enfermedad en el periodo de seguimiento del 100% y la mortalidad cáncer-específica del 0%. AbstractIntroduction: The aim of the study is to analyze, based on patients treated in our department of upper urinary tract tumors, epidemiological and clinical characteristics as well as the variables that have influenced the evolution and mortality of these patients Material and methods: 32 patients diagnosed of upper urinary tract tumors in Santa Ana Hospital of Motril (Granada) between January 2003 and December 2013 were retrospectively analyzed. Results: The mean age was 72.25 years. 75% were male and 25% female. 71.9% were hypertensive, 46.9% were smokers. 18.8% had a bladder tumor at diagnosis. 90.6% debuted with hematuria.53.1% was located on the right side and 43.8% on the left. 25% were developed in the chalices, 46.8% in the renal pelvis and ureteral 50%.The pathologic stage at diagnosis: 6.3% Ta, 25% T1, 28.1% T2, 37.5% T3 and 3.1% T4. 21.9% were grade I, grade II 34.4% and 43.8% grade III. No tumor recurrence was observed in any patient being cancer -specific mortality of 0%. In 8 patients bladder tumor was diagnosed during follow-up. The mean hospital stay was 7 days. Conclusions: Despite being limited casuistry the results are satisfactory regardless of the surgical technique used, being disease-free survival in the follow-up period of 100% and cancer-specific mortality of 0%. Enviado: 02-12-2014 Revisado: 22-12-2014 Aceptado: 29-12-...

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“…Desde hace dos dé cadas, la TC es el mé todo de elecció n en el diagnó stico y la estadificació n de los adenocarcinomas renales [22][23][24] . Han sido debatidas durante añ os la sensibilidad y la especificidad de la TC en el diagnó stico de TU, pero diferentes estudios han demostrado la superioridad de la TC en el diagnó stico de este tipo de tumores, tanto en el tracto urinario superior como en la vejiga [22][23][24] .…”

Section: Tomografía Computarizadaunclassified

La urografía intravenosa ha muerto,¡viva la tomografía computarizada!

Franco¹,

Tomás²,

Alonso-Burgos³

2010

Actas Urol Esp

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informació n del artí culo Durante la ú ltima mitad del siglo XX se han producido cambios muy importantes en el campo de la imagen genitourinaria, de forma que para la mayor parte de las histó ricas indicaciones de la urografía intravenosa la tomografía computarizada (TC) es ahora la té cnica de elecció n.El objetivo de este trabajo es realizar una actualizació n del correcto uso de las pruebas de imagen, con especial enfoque en la TC, en la patología uroló gica del adulto revisando las entidades má s frecuentes: litiasis, hematuria, infecciones, tumores, controles de cirugía y pielectasia.Hacemos un breve recorrido histó rico por las pruebas de imagen utilizadas en urología a travé s de los añ os, haciendo hincapié en sus fundamentos físicos.En la segunda parte revisamos las diferentes patologías uroló gicas y el papel que desempeñ an la radiografía simple, la ecografía, la TC y la resonancia magné tica, analizando su sensibilidad y su especificidad.Por ú ltimo, hacemos una breve reflexió n acerca de las dosis de radiació n de los diferentes mé todos radioló gicos. The aim of this report is to perform an update in the correct use of the imaging techniques in the adult-related most frequent urological pathology, including: urolithiasis, haematuria, infections, tumours, surgery follow-up and pyelectasis, specially focused in CT.A brief historical review of the urological imaging techniques is performed, emphasizing the physical principles.

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Multidetector Computerized Tomography Urography is More Accurate Than Excretory Urography for Diagnosing Transitional Cell Carcinoma of the Upper Urinary Tract in Adults With Hematuria

Cited by 96 publications

References 20 publications

The economic implications of unsuspected findings from CT urography performed for haematuria

The economic implications of unsuspected findings from CT urography performed for haematuria

Descriptive analysis of a series of 32 upper urinary tract tumors in a second level hospital

La urografía intravenosa ha muerto,¡viva la tomografía computarizada!

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