Multidetector Computerized Tomography Urography as the Primary Imaging Modality for Detecting Urinary Tract Neoplasms in Patients With Asymptomatic Hematuria
2008; Lippincott Williams & Wilkins; Volume: 179; Issue: 3 Linguagem: Inglês
10.1016/j.juro.2007.10.061
ISSN1527-3792
AutoresGary S. Sudakoff, Dell P. Dunn, Michael L. Guralnick, Robert S. Hellman, Daniel Eastwood, William A. See,
Tópico(s)Ureteral procedures and complications
ResumoNo AccessJournal of UrologyAdult urology1 Mar 2008Multidetector Computerized Tomography Urography as the Primary Imaging Modality for Detecting Urinary Tract Neoplasms in Patients With Asymptomatic Hematuria Gary S. Sudakoff, Dell P. Dunn, Michael L. Guralnick, Robert S. Hellman, Daniel Eastwood, and William A. See Gary S. SudakoffGary S. Sudakoff Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin , Dell P. DunnDell P. Dunn Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas , Michael L. GuralnickMichael L. Guralnick Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin , Robert S. HellmanRobert S. Hellman Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin , Daniel EastwoodDaniel Eastwood Department of Population Health, Medical College of Wisconsin, Milwaukee, Wisconsin , and William A. SeeWilliam A. See Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin View All Author Informationhttps://doi.org/10.1016/j.juro.2007.10.061AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined whether multidetector computerized tomography urography is sensitive and specific for detecting urinary tract neoplasms when used as the primary imaging modality for evaluating patients with hematuria. Materials and Methods: A retrospective review was performed of the radiological, urological and pathological records of 468 patients without a history of urinary neoplasms who presented with hematuria. All patients underwent multidetector computerized tomography urography and complete urological evaluation, including cystoscopy. Laboratory urinalysis and cytology were done in 350 and 318 of the 468 patients, respectively. Multivariate logistic regression analysis was performed using the variables multidetector computerized tomography urography diagnosis, worst urine cytology, number of red blood cells per high power field, gross hematuria, age and gender to predict urinary tract neoplasm. Results: A total of 50 urinary neoplasms were diagnosed in 468 patients. Multidetector computerized tomography urography detected 32 of 50 neoplasms for a sensitivity of 64%, specificity of 98%, positive predictive value of 76% and negative predictive value of 96%. There were 10 false-positive and 18 false-negative multidetector computerized tomography urography studies. Multivariate logistic regression showed that abnormal multidetector computerized tomography urography findings, ie neoplasm (p <0.0001), and suspicious or positive urine cytology (p = 0.0009) were significant. Patients with an abnormal multidetector computerized tomography urography diagnosis and suspicious or positive urine cytology had 44 and 47 times greater odds, respectively, of having urinary neoplasms compared to the odds in those with normal examinations. Conclusions: Multidetector computerized tomography urography is relatively sensitive and highly specific for detecting urinary neoplasms. It may serve as the primary imaging modality to evaluate patients with hematuria. Multidetector computerized tomography urography does not eliminate the role of cystoscopy in the evaluation of hematuria. References 1 : Multislice CT urography: state of the art. Br J Radiol2004; 77: S74. 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Google Scholar 20 : Urinary tract abnormalities: initial experience with multi-detector row CT urography. Radiology2002; 222: 353. Google Scholar © 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byWang L, Wong Y, Ng K, Chuang C, Lee S and Wan Y (2010) Tumor Characteristics of Urothelial Carcinoma on Multidetector Computerized Tomography UrographyJournal of Urology, VOL. 183, NO. 6, (2154-2160), Online publication date: 1-Jun-2010.Takahashi N, Glockner J, Hartman R, King B, Leibovich B, Stanley D, Fitz-Gibbon P and Kawashima A (2010) Gadolinium Enhanced Magnetic Resonance Urography for Upper Urinary Tract MalignancyJournal of Urology, VOL. 183, NO. 4, (1330-1336), Online publication date: 1-Apr-2010. Volume 179Issue 3March 2008Page: 862-867 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsurinary tracthematuriax-ray computedtomographyneoplasmsbladderMetricsAuthor Information Gary S. Sudakoff Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin More articles by this author Dell P. Dunn Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas More articles by this author Michael L. Guralnick Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin Financial interest and/or other relationship with Novartis, Pfizer and Boston Scientific. More articles by this author Robert S. Hellman Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin Financial interest and/or other relationship with GE Medical Systems. More articles by this author Daniel Eastwood Department of Population Health, Medical College of Wisconsin, Milwaukee, Wisconsin More articles by this author William A. See Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin Financial interest and/or other relationship with AstraZeneca. More articles by this author Expand All Advertisement PDF downloadLoading ...
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