The Pyelographic and Roentgenologic Diagnosis of Renal Tumors

Imaging the Renal Mass: A Historical Review

“…Visualization of the ureters and installation of radiopaque substances documented with x-ray plates followed within a few years (3,4). Creation of a map of the upper collecting systems (pyelography) from below (so-called instrumental pyelography) was the early anatomic standard and was aided by cystoscopic bladder access (3)(4)(5)(6)(7)(8). Retrograde pyelography followed these early efforts and was the prevailing urologic imaging technique; it jousted for a major role well into the middle of the 20th century, even after the introduction of excretory urography and intravenous pyelography (6).…”

“…Before the introduction of the first intravenous contrast material, retrograde injection of radiopaque substances into the ureter (ie, colloidal silver solutions, 5% collargol, and 25% sodium bromide and potassium iodide) was the prevailing urologic practice (3,(7)(8)(9). Interestingly, sodium salts were preferable for retrograde pyelography, as urologists depicted intrarenal anatomy in a static sense with conventional radiography (8); this presaged the use of sodium salts of modern ionic contrast media, which was yet to come.…”

“…Calyceal distortion patterns were described for renal tumors. Terms like pyeloscopy and uroscopy were coined to describe fluoroscopic and radiographic imaging of the filled urinary tract in a retrograde fashion (4,6,7). It is difficult to say, in retrospect, who was the first to radiographically depict a renal mass or how he or she depicted it.…”