With a three-phase CT urographic protocol, significant dose reductions in the unenhanced and excretory phases can be achieved when these phases are combined with a normal-dose corticomedullary phase.
• More bladder tumours are detected during the corticomedullary phase than during other phases. • Sensitivity and NPV for bladder cancer detection were highest in corticomedullary phase. • The corticomedullary phase in CT urography should be used for bladder assessment.
The detection rate of bladder tumours for the CTU protocol including an enhancement-triggered scan was high and comparable to flexible cystoscopy. Hence, this protocol could be used to assess the bladder as the primary investigation and direct further investigation of the patient.
The contrast enhancement is significantly higher in the CMP than in the NP and EP, suggesting that the CMP is preferable when assessing the bladder in the early contrast enhancing phase.
This study shows that the individual mean effective dose to patients undergoing CT urography has decreased by 60%, from 29.9/22.5 (F/M) mSv in 1997 to 11.7/8.8 (F/M) mSv in 2008.
Optimal electrode placement and a long distance from the collecting system are associated with an increased primary efficacy of renal tumor RFA. These variables need to be considered to increase primary ablation success. Further studies are needed to evaluate the effect of RFA on histopathologically different renal tumors.
The cortical phase was best for characterisation of renal parenchymal tumours. The nephrographic and excretory phases were best in detecting and characterising renal cysts. The nephrographic phase was the phase giving the least diagnostic information.
If small (<4 cm) RCCs do not cause symptoms, patients with them will not be referred for CT or any other imaging modality. Therefore, if a 2-cm RCC is found in a patient presenting with macroscopic hematuria, it is unlikely that this small RCC caused the hematuria and another cause of the hematuria must be ruled out.
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