Multi-Detector row CT urography on a 16-row CT scanner in the evaluation of urothelial tumors

Tsili, Athina C.; Efremidis, Stavros C.; Kalef-Ezra, J.; Giannakis, Dimitrios; Alamanos, Yiannis; Sofikitis, Nikolaos; Tsampoulas, C.

doi:10.1007/s00330-006-0383-2

Cited by 51 publications

(37 citation statements)

References 25 publications

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“…Last, DECT urography did not expose more radiation to patients than single-energy CT urography. Several studies reported that mean effective dose ranges 20-30 mSv at single-energy CT urography [20][21][22]. This dose is slightly higher than that in our study (16.3 mSv).…”

Section: Discussioncontrasting

confidence: 74%

“…All patients underwent threephase CT imaging to scan the area between the liver and symphysis pubis. First, a UCT scan was acquired and then nephrographic and excretory CT scans were performed at 100 s and 8 min (n529) or 12 min (n53) after intravenous injection of 120 ml contrast material (ultravist 300; Bayer Schering Pharma, Berlin, Germany) at the rate of 3 ml s 21 . Prior to the 8 min excretory CT, furosemide was administered to 29 patients.…”

Section: Ct Imagingmentioning

confidence: 99%

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Evaluation of virtual unenhanced CT obtained from dual-energy CT urography for detecting urinary stones

Moon

Park²,

Kim³

et al. 2012

BJR

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Objective: The aim of our study was to determine if virtual unenhanced CT (VUCT) is equivalent to unenhanced CT (UCT) for detecting urinary stones. Methods: Our institutional review board approved this retrospective study, which was compliant with the Health Insurance Portability and Accountability Act. A total of 80 stones were detected in 32 patients among 146 consecutive patients undergoing dualenergy CT urography. The number and size of stones were recorded on nephrographic VUCT (NVUCT) and excretory VUCT (EVUCT) images, respectively. UCT was a reference of standard for the number and size of stones. Image quality of VUCT was qualitatively assessed using a five-point scale. Repeated-measures analysis of variance with post-test was used for statistical analysis. Results: 62 stones in 29 patients were detected on NVUCT and 59 stones in 27 patients were detected on EVUCT. The size of stones detected on NVUCT or EVUCT was significantly smaller compared with stones on UCT (p,0.05). The size of stones detected on UCT, NVUCT and EVUCT ranged from 1.4 to 19.2 mm (mean, 4.6 mm), 0 to 19.2 mm (mean, 3.6 mm) and 0 to 18.7 mm (mean, 3.6 mm), respectively. 18 stones were missed on NVUCT and 21 were missed on EVUCT. The sizes ranged from 1.4 to 3.2 mm (mean, 2.1 mm) and 1.4 to 3.2 mm (mean, 2.2 mm) on UCT, respectively. VUCT was inferior to UCT regarding image quality (p,0.05). Conclusion: VUCT missed a significant number of small stones probably owing to poor image quality compared with UCT. Subsequently, VUCT cannot replace UCT for detecting urinary stones. Urolithiasis is a common cause of haematuria. Unenhanced CT (UCT) is considered a gold standard for diagnosing this disease entity because it is more sensitive to detecting urinary stones than simple radiography and ultrasound [1][2][3]. Therefore, UCT is an essential CT protocol that should be included for CT urography. Dual-energy CT (DECT) imaging can reconstruct virtual unenhanced CT (VUCT) images from contrastenhanced CT images. As VUCT is equivalent to UCT in characterising renal masses, radiation dose to patients can be reduced during CT scans using dual-energy sources [4,5]. DECT is also useful in evaluating composition of urinary stones, uric acid stones can be differentiated from calcified stones [6][7][8][9][10]. However, there are few in vitro or in vivo reports about the validity of VUCT in detecting urinary stones [11][12][13]. Still, it is unclear whether or not VUCT can be an alternative imaging to UCT for diagnosing urolithiasis.The purpose of our study was to determine whether or not VUCT is equivalent to UCT in detecting urinary stones. Methods and materialsThis retrospective study was approved by our institutional review board and informed consent was waived. PatientsBetween September 2009 and March 2010, a total of 146 patients (male-to-female ratio, 73:73; age range, 23-87 years; mean age 56 years) underwent CT urography due to one of the following chief complaints: microscopic haematuria (n560), gross haematuria (n525), flank discomfort (n546) ...

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Section: Discussioncontrasting

confidence: 74%

Section: Ct Imagingmentioning

confidence: 99%

Evaluation of virtual unenhanced CT obtained from dual-energy CT urography for detecting urinary stones

Moon

Park²,

Kim³

et al. 2012

BJR

View full text Add to dashboard Cite

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“…Studies focusing on CTU in patients with microscopic haematuria show that causes for haematuria are identified in 33.0-42.6% with overall CTU sensitivity for identification of the cause of haematuria of 92.4-100% and specificity of 89.0-97.4% [8][9][10][11][12][13]. In studies on microscopic or unselected haematuria upper tract TCC was present in 0.9-7.3% [8,11,14].…”

Section: Indicationsmentioning

confidence: 98%

CT urography: definition, indications and techniques. A guideline for clinical practice

et al. 2007

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The aim was to develop clinical guidelines for multidetector computed tomography urography (CTU) by a group of experts from the European Society of Urogenital Radiology (ESUR). Peer-reviewed papers and reviews were systematically scrutinized. A summary document was produced and discussed at the ESUR 2006 and ECR 2007 meetings with the goal to reach consensus. True evidence-based guidelines could not be formulated, but expert guidelines on indications and CTU examination technique were produced. CTU is justified as a first-line test for patients with macroscopic haematuria, at high-risk for urothelial cancer. Otherwise, CTU may be used as a problem-solving examination. A differential approach using a one-, two- or three-phase protocol is proposed, whereby the clinical indication and the patient population will determine which CTU protocol is employed. Either a combined nephrographic-excretory phase following a split-bolus intravenous injection of contrast medium, or separate nephrographic and excretory phases following a single-bolus injection can be used. Lower dose (CTDIvol 5-6 mGy) is used for benign conditions and normal dose (CTDIvol 9-12 mGy) for potential malignant disease. A low-dose (CTDIvol 2-3 mGy) unenhanced series can be added on indication. The expert-based CTU guidelines provide recommendations to optimize techniques and to unify the radiologist's approach to CTU.

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“…Renal parenchymal abnormalities, particularly masses, are best visualized on nephrographic phase images, which also provide excellent evaluation of the other abdominal organs. Excretory phase images obtained from the kidneys to the bladder demonstrate the urinary tract distended with contrast material and are useful in detecting papillary/ calyceal abnormalities as well as urothelial disease [1,11,12]. Although CT may also demonstrate bladder disease, flat tumors of the bladder are unlikely to be identified with CT, and cystoscopy remains the study of choice in evaluating for bladder malignancy.…”

Section: Introductionmentioning

confidence: 97%

“…Dose management technology in CT has led to optimization of CT protocols using angular (x and y-axes), longitudinal (z-axis), or combined (x, y, and z-axes) modulation of the dose; in some modern systems, this can also be combined with 3D adaptive noise filtration [1,11,12].…”

Section: Introductionmentioning

confidence: 99%

CT Urography

Mileto¹,

Chrisafi²,

Mazziotti³

et al. 2013

CT of the Retroperitoneum

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Multi-Detector row CT urography on a 16-row CT scanner in the evaluation of urothelial tumors

Cited by 51 publications

References 25 publications

Evaluation of virtual unenhanced CT obtained from dual-energy CT urography for detecting urinary stones

Evaluation of virtual unenhanced CT obtained from dual-energy CT urography for detecting urinary stones

CT urography: definition, indications and techniques. A guideline for clinical practice

CT Urography

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