CT urography helps diagnose cancers


NEW YORK (Reuters Health), Jul 4 - Multidetector computed tomography urography (MDCTU) is effective in diagnosing upper urinary tract urothelial tumors, according to U.K. researchers.

"MDCTU represents a significant advance in the diagnostic imaging techniques available for investigation of hematuria and urological cancer," lead investigator Dr. Nigel C. Cowan told Reuters Health.

"Evidence is accumulating for MDCTU to be the first choice investigation for patients at high risk for urological cancer," he added.

In the June issue of BJU International, Dr. Cowan and colleagues at the Churchill Hospital, Oxford note that they employed both MDCTU and retrograde ureteropyelography (RUP) in 106 such patients.

In 151 tumors thus evaluated, the investigators established an MDCTU sensitivity of 0.97 and a specificity of 0.93. The positive predictive value was 0.79 and the negative predictive value was 0.99. These figures were identical to those achieved in the 143 evaluations successfully conducted via RUP.

Given these findings, the researchers conclude that "MDCTU should therefore be used before RUP, as it is a single noninvasive comprehensive test that allows simultaneous diagnosis and/or staging."

"Diagnosis may be accelerated by streamlining the investigative pathway for urological cancer by early use of MDCTU, allowing less sensitive and specific tests to be bypassed," Dr. Cowan said.

Nevertheless, he concluded, "optimum use of MDCTU in clinical practice is still to be achieved, and will depend on greater availability of CT, clinicians' understanding, as well as radiologists' expertise and education."

By David Douglas

Last Updated: 2007-07-03 15:00:12 -0400 (Reuters Health)

BJU Internat 2007;99:1363-1370.

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