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Conventional CT signs in staging transitional cell tumors of the upper urinary tract
F Millán-Rodríguez1, J Palou, P de la Torre-Holguera
1Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain.
Objectives:
To determine conventional computed tomography (CT) signs in the diagnosis and staging of upper urinary tract tumors (UUTTs).
Methods:
Retrospective study was made of the CTs of 82 patients diagnosed with UUTTs. Nine CT signs were defined and compared with the pathology of the surgical specimen. A chi2 test was used for statistical analyses.
Results:
We reviewed the CTs of 93 UUTTs in 82 patients, of which 36% were invasive and 12% had positive lymph nodes. Renal parenchymal invasion was found in 82% of high-grade and in 18% of low-grade tumors (p = 0.001). 94% of the tumors with signs of renal parenchymal invasion were invasive (p < 0.001), as well as 88% of those appearing as renal masses (p = 0.005), with a global sensitivity of 64% and specificity of 97%. The CT sensitivity and specificity of detecting infiltration of the ureter was 67 and 77%, respectively, and no sign was statistically significant. The detection of lymph node involvement had a sensitivity of 87.5% and a specificity of 98%.
Conclusions:
CT offers good sensitivity (87.5%) and specificity (98%) in the detection of lymph node involvement, and 64% sensitivity and 97% specificity for the detection of renal tumor invasion.