MDCT Urography of Upper Tract Urothelial Neoplasms

Caoili, Elaine M.; Cohan, Richard H.; Inampudi, Prasuna; Ellis, James H.; Shah, Rajal B.; Faerber, Gary J.; Montie, James E.

doi:10.2214/ajr.184.6.01841873

Cited by 178 publications

(100 citation statements)

References 24 publications

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“…They are classified into autosomal diseases, when the gene is not located on the sex chromosomes, and X-linked, in the case in which the disease gene is localized in the female sex chromosome. (23,24,25,26)They are also divided into dominant and recessive diseases, depending on which is sufficient only one copy or two copies of the mutated gene to determine the disease. d) multifactorial or complex.…”

Section: Discussion:-mentioning

confidence: 99%

Congenital Anomalies of the Kidney and Urinary Tract Neoplasms and in the Elderly.

G¹,

Cataldo.²

2017

IJAR

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Introduction: Congenital abnormalities of the kidneys and urinary tract represented a spectrum of malformations often grouped under the acronym for CAKUT. Normal development of the kidneys and urinary tract is the result of the precise interaction, spatially and temporally coordinated, between two structures, the metanephric mesenchyme (which originates from the nephrogenic cord) and the ureteric bud (which originates from nefrico duct or Wolff). Any alteration, it's genetic, environmental, or stochastic, which influence this process can result in kidney malformations and streets urinariedel present study is to evaluate in relation to clinical attention the incidence of risk in neoplastic 'association cancer and malformation. in adults Materials end Methods: Male patient of 75 suffering from gross hematuria and hernia inquinale sn accompanied by dysuria symptoms, in heavy smoker instrumental ultrasound examination of the urinary tract showed a solid lesion in the posterolateral wall sn aggittante in the bladder lumen The uro-CT examination showed a " abnormality of the urinary tract development with ectopia crusade and merger of the two kidneys located alongside sn (fot, 3.4) of the renal pelvis are addressed before the district complete with double ureteral sn .In at the urethral meatus will highlight a focal thickening protruding into the lumen wall to finely irregular margins, with enhancement after contrast medium. (photo 5.6) the CT examination conducted in the chest (photo 7) confirmed the marked signs of emphysema, the anterior segment of the left upper lobe, in close relationship with bronchus and vessels segmented solid training in margins lobed (29x20 mm axial diameter approximately). At PET-CT accumulation of the tracer in the upper field of the left lung in the paramedian attributable to non-specific reactive process . Fig (8.9), then he performed genetic test that confirmed mutations in the PAX2 Results: The UroCT is the imaging examination with greater sensitivity and specificity. The limit lies in the poor ability to detect flat lesions non-invasive muscle. The urography has been almost entirely supplanted by UroTC. The current biomarkers do not have a sensitivity and specificity greater than urinary cytology, and The aromatic amines, NAT2 and NAT1 of tobacco smoking products, are considered the

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Section: Discussion:-mentioning

confidence: 99%

Congenital Anomalies of the Kidney and Urinary Tract Neoplasms and in the Elderly.

G¹,

Cataldo.²

2017

IJAR

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“…9 Although this endoscopic navigation is useful, the technique has some tumor detection limitations in comparison with axial images. 10 In other studies, multidetector CT urography exhibited an excellent ability to find renal tumors but had some limitations in the identification of ureteral tumors. 11 …”

Section: By Exploiting the Extra Information Available From 3d Imaginmentioning

confidence: 97%

Virtual reality may improve training of renal surgeons

Martínez¹,

Chalasani²

2009

SPIE Newsroom

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By exploiting the extra information available from 3D imaging in a virtual reality environment, surgeons can individualize the pre-planning of surgery on the kidneys.The most frequent kidney cancer in adults is renal cell carcinoma. Certain features limit the successful treatment of this tumor, including resistance to radiotherapy and chemotherapy, so renal surgery is generally the best strategy to cure these patients.Renal surgery is one of the more challenging procedures for today's urologist. Cure with a single procedure is a huge responsibility, especially with the complex anatomy involved and the major complications that can occur as a result of decisions during the surgery. However, partial kidney resections have undeniable advantages with respect to renal function preservation. In particular, minimally invasive procedures (laparoscopic, robotic, cryotherapeutic, and radiofrequency) have quite favorable cure rates, recovery times, medication requirements, blood loss, cosmetic results, and hospitalization lengths. These less invasive techniques also have limitations and additional difficulties for the urologist, including loss of tactile feedback, longer operating times (which impact renal blood supply), and learning curves.Diagnostic imaging with computed tomography (CT) and magnetic resonance imaging (MRI) detects, characterizes and determines the stage of the disease. Other critical information obtained from these studies includes the number and localization of blood vessels, depth of the tumor, multifocality of disease, and involvement of adjacent organs. A comprehensive understanding of these factors allows the urologist to plan the surgery without invasive diagnostic procedures. 1, 2 Other researchers have refined this pre-planning step with the imaging system in a 3D environment. 3 The most frequent application of 3D imaging and virtual reality in urological practice is probably renal surgery (see Figures 1 and 2), as the analysis of tumoral features and anatomy allows the surgeon to design a tailored approach for each particular case. 1, 2, 4 Our group developed a virtual reality model of renal tumor images that a urologist can manipulate on a laptop computer inside the operating room to obtain accurate information about the case. 5 Other groups have also recreated surgical resections of renal tumors using virtual reality. These models allow the surgeon to visualize the spatial relationships of pathological and physiological features in each case, and hence avoid unexpected intraoperative injuries in cases with complex anatomy. [6][7][8] Several techniques incorporating 3D imaging systems are currently used in clinical practice. Development of CT scanners with multi-detectors as well as new hardware and software allows endoscopic virtual navigation through the ureters, which aids in detection of small urothelial malignant lesions. 9 Although this endoscopic navigation is useful, the technique has some tumor detection limitations in comparison with axial images. 10 In other studies, multidetector CT...

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“…Moreover, CT is more sensitive than ultrasonography or IVU in the identification of upper tract lesions [7]. A CT scan of the abdomen and pelvis may also provide some clinical information regarding the pelvic and retroperitoneal lymph node or the presence of any liver lesions [16,17]. CT is useful for detecting metastases, but it may be inadequate for detecting and staging local urothelial lesions, if not correctly performed.…”

Section: Ct Imagingmentioning

confidence: 99%

“…In terms of cancer staging, CTU can detect direct perirenal, periureteral and extravesical tumor spread, as well as lymphadenopathy and distant metastases. Compared with traditional excretory urography, CTU requires a shorter examination time and has greater accuracy for detecting urothelial lesions [16]. CTU also allows more detailed evaluation of the renal parenchyma and perirenal tissues and permits better evaluation of obstructed collecting systems than excretory urography [17].…”

Section: Reviewmentioning

confidence: 99%