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Diagnostic accuracy of transitional cell carcinoma on multidetector computerized tomography urography in patients

Li-Jen Wang1, Yon-Cheong Wong, Cheng-Keng Chuang

  • 1Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China. lijenwang0918@gmail.com

The Journal of Urology
|December 23, 2008
PubMed

Insights

Multidetector computerized tomography urography (MDCT-U) accurately diagnoses transitional cell carcinoma in patients with gross hematuria. Prospective readings showed higher accuracy than retrospective readings, especially for renal tumors.

Area of Science:

  • Urology
  • Radiology
  • Oncology

Background:

  • Transitional cell carcinoma (TCC) is a significant cause of hematuria.
  • Early and accurate diagnosis is crucial for effective treatment and patient outcomes.
  • Multidetector computerized tomography urography (MDCT-U) is a noninvasive imaging technique.

Purpose of the Study:

  • To evaluate the diagnostic performance of MDCT-U for detecting TCC in patients presenting with gross hematuria.
  • To compare the accuracy of prospective versus retrospective readings of MDCT-U scans.
  • To assess the diagnostic value of MDCT-U across different locations of the urinary tract.

Main Methods:

  • Prospective enrollment of adult patients with gross hematuria undergoing MDCT-U.
  • Recording of TCC presence and location during prospective and retrospective MDCT-U readings.
  • Histological confirmation of TCC served as the gold standard.
  • Exclusion of patients with incomplete follow-up or diagnostic data.

Main Results:

  • 115 patients were included in the analysis, with 60 diagnosed with 77 TCCs.
  • Overall accuracy for MDCT-U was high, with prospective readings achieving 98.4% accuracy.
  • MDCT-U demonstrated highest accuracy for renal pelvis TCC and lowest sensitivity for ureteral TCC.

Conclusions:

  • MDCT-U is a highly accurate and noninvasive tool for diagnosing TCC in patients with gross hematuria.
  • Prospective interpretation of MDCT-U scans enhances diagnostic accuracy.
  • Careful evaluation of the ureter is necessary to avoid missing ureteral TCCs.
Abstract

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