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Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
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Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
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Imaging Studies II: Ultrasonography01:24

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IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
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This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
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Split-bolus CT urogram: Is less more?

Hiram Shaish1, Jeffrey H Newhouse2

  • 1Department of Radiology, Columbia University Medical Center, 622 West 168th Street, PB-1-301, New York, NY, 10032, USA.

Abdominal Radiology (New York)
|March 9, 2017
PubMed
Summary
This summary is machine-generated.

Split-bolus CT urography (SB-CTU) effectively detects upper tract urothelial carcinoma (UCA) with high sensitivity. However, false positives can occur, necessitating careful consideration of advanced CT urography protocols.

Keywords:
CT urogramSplit bolusTransitional cell carcinomaUpper tractUrothelial carcinoma

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Area of Science:

  • Radiology
  • Urologic Oncology
  • Diagnostic Imaging

Background:

  • Upper urinary tract urothelial carcinoma (UCA) diagnosis relies on accurate imaging.
  • Split-bolus CT urography (SB-CTU) is a common diagnostic tool.
  • The diagnostic accuracy of SB-CTU without special maneuvers for ureteral distention is under investigation.

Purpose of the Study:

  • To evaluate the accuracy of SB-CTU without special maneuvers for diagnosing upper urinary tract UCA.
  • To determine the sensitivity, specificity, and predictive values of SB-CTU for UCA detection.

Main Methods:

  • Retrospective review of SB-CTU exams performed between 2010 and 2015.
  • Comparison of prospective radiology reports with cystoscopy, ureteroscopy, and clinical follow-up (minimum 12 months).
  • Calculation of diagnostic performance metrics for upper and lower urinary tract UCA.

Main Results:

  • 339 SB-CTU studies in 334 patients were analyzed.
  • Prevalence of upper tract UCA was 1.5% and bladder tumors was 9.7%.
  • SB-CTU demonstrated 80% sensitivity and 99% specificity for upper tract UCA, with an 80% sensitivity and 99% specificity for bladder tumors. Positive predictive value for upper tract UCA was 44%.

Conclusions:

  • SB-CTU without special maneuvers is highly sensitive for detecting upper tract UCA.
  • The low positive predictive value indicates a significant rate of false positives.
  • The clinical utility of more complex CT urography protocols should be balanced against cost and radiation exposure.