Differentiation of Upper Urinary Tract Lesions Using MDCT: Benign Vs Malignant

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Distinguishing benign from malignant upper urinary tract (UUT) lesions is crucial for patient management.
• Multiple detector computed tomography (MDCT) is a widely used imaging modality for evaluating UUT abnormalities.

Purpose of the Study:

• To assess the diagnostic accuracy of MDCT in differentiating benign and malignant lesions of the UUT.
• To identify specific CT features indicative of malignancy in UUT lesions.

Main Methods:

• A study included 54 patients with 55 suspected UUT lesions, all undergoing MDCT with nephrographic and excretory phases.
• Diagnostic accuracy was evaluated using logistic regression and classification/regression tree analysis.
• Histology confirmed the final diagnosis for most lesions, with MDCT follow-up for others.

Main Results:

• Mass morphology was significantly associated with a higher probability of malignancy (OR: 3.73, p=0.047).
• Irregular internal borders strongly indicated malignancy (OR: 12.14, p<0.001).
• Lesion size, calcifications, and enhancement did not show significant associations with malignancy.

Conclusions:

• MDCT features, specifically mass morphology and irregular internal borders, are reliable indicators for suggesting malignancy in UUT lesions.
• These findings can aid clinicians in the differential diagnosis of UUT lesions.