دورية أكاديمية
أعرض في EDS

Is the excretory phase necessary to identify upper tract urothelial neoplasms at CT urography? A 10-year population-based study.

التفاصيل البيبلوغرافية
العنوان: Is the excretory phase necessary to identify upper tract urothelial neoplasms at CT urography? A 10-year population-based study.
المؤلفون: Limaye W; Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Victoria General Building, 3rd floor, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada., Fenwick A; Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Victoria General Building, 3rd floor, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada., Mason R; Department of Urology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Victoria General Building, 5th floor, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada., Costa AF; Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Victoria General Building, 3rd floor, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada. andreufcosta@gmail.com.
المصدر: Abdominal radiology (New York) [Abdom Radiol (NY)] 2024 Jul; Vol. 49 (7), pp. 2296-2304. Date of Electronic Publication: 2024 May 17.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: United States NLM ID: 101674571 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2366-0058 (Electronic) NLM ISO Abbreviation: Abdom Radiol (NY) Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [New York] : Springer, [2016]-
مواضيع طبية MeSH: Tomography, X-Ray Computed*/methods , Urography*/methods, Humans ; Male ; Female ; Aged ; Retrospective Studies ; Urologic Neoplasms/diagnostic imaging ; Contrast Media ; Carcinoma, Transitional Cell/diagnostic imaging ; Registries ; Middle Aged ; Aged, 80 and over
مستخلص: Purpose: To assess the proportion of upper tract urothelial carcinomas (UTUC) that are evident without the excretory phase at CT urography (CTU), and the proportion of potentially avoidable radiation.
Methods: UTUCs diagnosed between January 2008-December 2017 were retrospectively identified from a population-based cancer registry. For each patient, US, non-urographic CT, and MRI exams were assessed for a primary mass and secondary imaging findings (hydronephrosis, urinary tract thickening, luminal distention, fat stranding, and lymphadenopathy/metastatic disease). CTUs were assessed for primary and secondary findings, and whether the tumor was evident as a filling defect on excretory phase. The dose-length product (DLP) of potentially avoidable excretory phases was calculated as a fraction of total DLP.
Results: 288 patients (mean age, 72±11 years, 165 males) and 545 imaging examinations were included. Of 192 patients imaged with 370 non-urographic CTs, a primary mass was evident in 154 (80.2%), secondary findings were evident in 172 (89.6%), and primary or secondary findings were evident in 179 (93.2%). Of 175 CTUs, primary and secondary findings were evident in 157 (89.7%) and 166 (94.9%) examinations, respectively, and primary or secondary findings were evident in 170/175 (97.1%). 131/175 (74.9%) UTUCs were evident as a filling defect, including the 5/175 (2.9%) UTUCs without primary or secondary findings. Of 144 CTUs with available DLP data, the proportion of potentially avoidable radiation was 103.7/235.8 (44.0%) Gy⋅cm.
Conclusion: In our population, almost all UTUCs were evident via primary or secondary imaging findings without requiring the excretory phase. These results support streamlining protocols and pathways.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
References: Wolfman D, Marko J, Nikolaidis P, Khatri G, Dogra V, Ganeshan D, Goldfarb S, Gore J, Gupta R, Heilbrun M, Lyshchik A, Purysko A, Savage S, Smith A, Wang Z, Wong-You-Cheong J, Yoo D, Lockhart M (2019) American College of Radiology Appropriateness Criteria Hematuria. https://acsearch.acr.org/docs/69490/Narrative/ . Accessed 14 January 2020.
Davis R, Jones JS, Barocas DA, Castle EP, Lang EK, Leveillee RJ, Messing EM, Miller SD, Peterson AC, Turk TM, Weitzel W, American Urological A (2012) Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. J Urol 188 (6 Suppl):2473–2481. https://doi.org/10.1016/j.juro.2012.09.078. (PMID: 10.1016/j.juro.2012.09.07823098784)
Nielsen M, Qaseem A (2016) Hematuria as a Marker of Occult Urinary Tract Cancer: Advice for High-Value Care From the American College of Physicians. Ann Intern Med 164 (7):488–497. https://doi.org/10.7326/m15-1496. (PMID: 10.7326/m15-149626810935)
Potenta SE, D’Agostino R, Sternberg KM, Tatsumi K, Perusse K (2015) CT Urography for Evaluation of the Ureter. Radiographics 35 (3):709–726. https://doi.org/10.1148/rg.2015140209. (PMID: 10.1148/rg.201514020925815907)
Silverman SG, Leyendecker JR, Amis ES, Jr. (2009) What is the current role of CT urography and MR urography in the evaluation of the urinary tract? Radiology 250 (2):309–323. https://doi.org/10.1148/radiol.2502080534. (PMID: 10.1148/radiol.250208053419188307)
Morrison N, Bryden S, Costa AF (2021) Split vs. Single Bolus CT Urography: Comparison of Scan Time, Image Quality and Radiation Dose. Tomography 7 (2):210–218. https://doi.org/10.3390/tomography7020019. (PMID: 10.3390/tomography7020019340652668163005)
Dahlman P, van der Molen AJ, Magnusson M, Magnusson A (2012) How much dose can be saved in three-phase CT urography? A combination of normal-dose corticomedullary phase with low-dose unenhanced and excretory phases. AJR Am J Roentgenol 199 (4):852–860. https://doi.org/10.2214/AJR.11.7209. (PMID: 10.2214/AJR.11.720922997378)
Gershan V, Homayounieh F, Singh R, Avramova-Cholakova S, Faj D, Georgiev E, Girjoaba O, Griciene B, Gruppetta E, Hadnadjev Simonji D, Kharuzhyk S, Klepanec A, Kostova-Lefterova D, Kulikova A, Lasic I, Milatovic A, Paulo G, Vassileva J, Kalra MK (2020) CT protocols and radiation doses for hematuria and urinary stones: Comparing practices in 20 countries. Eur J Radiol 126:108923. https://doi.org/10.1016/j.ejrad.2020.108923. (PMID: 10.1016/j.ejrad.2020.10892332171911)
Yecies T, Bandari J, Fam M, Macleod L, Jacobs B, Davies B (2018) Risk of Radiation from Computerized Tomography Urography in the Evaluation of Asymptomatic Microscopic Hematuria. J Urol 200 (5):967–972. https://doi.org/10.1016/j.juro.2018.05.118. (PMID: 10.1016/j.juro.2018.05.11829857078)
Waisbrod S, Natsos A, Wettstein MS, Saba K, Hermanns T, Fankhauser CD, Muller A (2021) Assessment of Diagnostic Yield of Cystoscopy and Computed Tomographic Urography for Urinary Tract Cancers in Patients Evaluated for Microhematuria: A Systematic Review and Meta-analysis. JAMA Netw Open 4 (5):e218409. https://doi.org/10.1001/jamanetworkopen.2021.8409. (PMID: 10.1001/jamanetworkopen.2021.8409339702578111485)
Skaggs AW, Loehfelm TW, Fananapazir G, Dall’Era M, Corwin MT (2021) Utilization and Yield of CT Urography: Are the American Urological Association Guidelines for Imaging of Patients With Asymptomatic Microscopic Hematuria Being Followed? AJR Am J Roentgenol 216 (1):106–110. https://doi.org/10.2214/AJR.20.22998. (PMID: 10.2214/AJR.20.2299832755213)
Fenwick AKC, Sala E, Canales DD (2020) Prevalence of Urologic Disease Among Patients Investigated for Hematuria With CT Urography. Can Assoc Radiol J:846537120902134. https://doi.org/10.1177/0846537120902134.
Hack K, Pinto PA, Gollub MJ (2012) Targeted delayed scanning at CT urography: a worthwhile use of radiation? Radiology 265 (1):143–150. https://doi.org/10.1148/radiol.12110548. (PMID: 10.1148/radiol.1211054822855323)
Rud E, Galtung KF, Lauritzen PM, Baco E, Flatabo T, Sandbaek G (2020) Examining the upper urinary tract in patients with hematuria-time to revise the CT urography protocol? Eur Radiol 30 (3):1664–1670. https://doi.org/10.1007/s00330-019-06521-0. (PMID: 10.1007/s00330-019-06521-031748856)
Metser U, Goldstein MA, Chawla TP, Fleshner NE, Jacks LM, O’Malley ME (2012) Detection of urothelial tumors: comparison of urothelial phase with excretory phase CT urography–a prospective study. Radiology 264 (1):110–118. https://doi.org/10.1148/radiol.12111623. (PMID: 10.1148/radiol.1211162322495683)
Shaish H, Newhouse JH (2017) Split-bolus CT urogram: Is less more? Abdom Radiol (NY) 42 (8):2119–2126. https://doi.org/10.1007/s00261-017-1098-3. (PMID: 10.1007/s00261-017-1098-328271274)
Galtung KF, Lauritzen PM, Sandbæk G, Bay D, Ponzi E, Baco E, Cowan NC, Naas AM, Rud E (2023) Is a Single Nephrographic Phase Computed Tomography Sufficient for Detecting Urothelial Carcinoma in Patients with Visible Haematuria? A Prospective Paired Noninferiority Comparison. European Urology Open Science 55:1–10. https://doi.org/10.1016/j.euros.2023.06.005. (PMID: 10.1016/j.euros.2023.06.0053769373210485786)
Kravchick S, Cherniavsky E, Verchovsky G, Peled R (2019) Multidetector Computed Tomographic Urography (MDCTU): Its Practical Role in Diagnosis of Upper Tract Urothelial Cancer in Patients 50 years and Older with Different Types of Hematuria. Pathology & Oncology Research 25 (1):249–254. https://doi.org/10.1007/s12253-017-0333-0. (PMID: 10.1007/s12253-017-0333-0)
Lisanti CJ, Toffoli TJ, Stringer MT, DeWitt RM, Schwope RB (2014) CT evaluation of the upper urinary tract in adults younger than 50 years with asymptomatic microscopic hematuria: is IV contrast enhancement needed? AJR Am J Roentgenol 203 (3):615–619. https://doi.org/10.2214/AJR.13.11891. (PMID: 10.2214/AJR.13.1189125148165)
Lokken RP, Sadow CA, Silverman SG (2012) Diagnostic yield of CT urography in the evaluation of young adults with hematuria. AJR Am J Roentgenol 198 (3):609–615. https://doi.org/10.2214/AJR.11.7296. (PMID: 10.2214/AJR.11.729622358000)
Halpern JA, Chughtai B, Ghomrawi H (2017) Cost-effectiveness of Common Diagnostic Approaches for Evaluation of Asymptomatic Microscopic Hematuria. JAMA Internal Medicine 177 (6):800–807. https://doi.org/10.1001/jamainternmed.2017.0739. (PMID: 10.1001/jamainternmed.2017.0739284184515818826)
Barocas DA, Boorjian SA, Alvarez RD, Downs TM, Gross CP, Hamilton BD, Kobashi KC, Lipman RR, Lotan Y, Ng CK, Nielsen ME, Peterson AC, Raman JD, Smith-Bindman R, Souter LH (2020) Microhematuria: AUA/SUFU Guideline. J Urol 204 (4):778–786. https://doi.org/10.1097/JU.0000000000001297. (PMID: 10.1097/JU.000000000000129732698717)
فهرسة مساهمة: Keywords: CT urography; Diagnostic performance; Excretory phase; Upper tract urothelial carcinoma
المشرفين على المادة: 0 (Contrast Media)
تواريخ الأحداث: Date Created: 20240517 Date Completed: 20240729 Latest Revision: 20240729
رمز التحديث: 20240729
DOI: 10.1007/s00261-024-04382-w
PMID: 38760531
قاعدة البيانات: MEDLINE
الوصف
تدمد:2366-0058
DOI:10.1007/s00261-024-04382-w