Computed tomography urography: trends in positivity rates over time

Area of Science:

• Radiology
• Urologic Imaging

Background:

• Computed tomography urography (CTU) is a key diagnostic tool in urology.
• Understanding trends in CTU utilization and diagnostic yield is crucial for optimizing patient care.

Purpose of the Study:

• To analyze changes in CTU usage, indications, and the rate of positive findings over time.
• To evaluate trends in specific diagnoses such as transitional cell carcinoma (TCC) and hematuria.

Main Methods:

• Retrospective review of 1746 CTU examinations from April 2000 to December 2005.
• Analysis of findings based on ordering physician specialty and indication for the examination.
• Assessment of rates for TCC, benign genitourinary (GU) findings, and non-GU findings.

Main Results:

• CTU examinations increased by 1.5-fold from 2001 to 2004.
• Urologists ordered 89% of CTUs, primarily for suspected GU malignancy (62%) and hematuria (24%).
• Overall positive findings varied between 37%-54% with no significant time trend; specific diagnoses like TCC, stones, and hematuria causes also showed stable rates.

Conclusions:

• Despite increased CTU use, the diagnostic yield for key urologic conditions has not changed.
• Careful adherence to proper indications for CTU can maintain its diagnostic value.
• CTU remains an important examination for high-risk patients when indications are appropriate.