Abstract
The aim of this study was to evaluate the potential of multiphasic multidetector-row CT (MDCT) in the detection and staging of transitional cell carcinomas (TCC) of the upper urinary tract. We performed a retrospective chart review of 39 consecutive patients with 41 histologically verified TCC of the renal pelvis and/or the ureter. The urinary tract was examined using MDCT performing unenhanced and contrast-enhanced scans during the corticomedullary (CMP), nephrographic (NP) and pyelographic phase (PP). Tumors were staged according to the TNM classification. MDCT and histopathological findings were correlated. The attenuation of the lesions was documented in Hounsfield units (HU). In MDCT, all 41 TCC—including two multicentric TCC—were detected. TCC confined to the organ (stage 0a-II) was correctly staged in 28/29 tumors (96.6%). Stage III-IV tumors were correctly staged in 8/12 patients (66.6%). Overall, MDCT was accurate in predicting pathologic TNM stage in 36/41 upper urinary tract TCC (87.8%). There was no significant difference of mean attenuation of TCC between CMP, NP and PP (P>0.05). MDCT with its high spatial and temporal resolution is an accurate tool for detection TCC of the upper urinary tract, with 87.8% accuracy in predicting its stage.
Similar content being viewed by others
References
Leder RA, Dunnick NR (1990) Transitional cell carcinoma of the pelvicalices and ureter. AJR AmJ Reontgenol 155:713—722
Urban BA, Buckley J, Soyer P, Scherrer A, Fishman EK (1997) CT appearance of transitional cell carcinoma of the renal pelvis: part 1. Early-stage disease. AJR AmJ Reontgenol 169:157–161
Urban BA, Buckley J, Soyer P, Scherrer A, Fishman EK (1997) CT appearance of transitional cell carcinoma of the renal pelvis: part 2. Advanced-stage disease. AJR AmJ Reontgenol 169:163–168
Baron RL, McClenman BL, Lee JKT, Lawson TL (1982) Computed tomography of transitional cell carcinoma of the renal pelvis and ureter. Radiology 144:125–130
McCoy JG, Honda H, Reznicek M, Williams RD (1991) Computerized tomography for detection and staging of localized and pathologically defined upper tract urothelial tumors. J Urol 146:1500–1503
Buckley J, Urban BA, Soyer P, Scherrer A, Fishman EK (1996) Transitional cell carcinoma of the renal pelvis : a retrospective look with pathologic correlation. Radiology 201:194–198
Nyman U, Oldbring J, Aspelin P (1992) CT of carcinoma of the renal pelvis. Acta Radiol 33:31–38
Schreyer HH, Uggowitzer MM, Ruppert-Kohlmayr A (2002) Helical CT of the urinary organs. Eur Radiol 12:575–591
American Joint Committee on Cancer (2002) Renal pelvis and ureter. In: AJCC Cancer Staging Manual, 6th edn. Springer, New York Berlin Heidelberg 329
Planz B, George R, Adam G, Jakse G, Planz K (1995) Computed tomography for detection and staging of transitional cell carcinoma of the upper urinary tract. Eur Urol 27:146–150
Huben RP, Mounzer AM, Murphy GP (1988) Tumor grade and stage as prognostic variables in upper tract urothelial tumors. Cancer 62:2016–2020
Rha SE, Byun JY, Jung SE, Oh SN, Choi YJ, Lee A et al (2004) The renal sinus: pathologic spectrum and multimodality imaging approach. Radiographics 24 (Suppl 1):S117
Scolieri MJ, Paik ML, Brown SL, Resnik MI (2002) Limitations of computer tomography in the preoperative staging of upper tract urothelial carcinoma. Urology 56:930
Badalament RA, Bennett WF, Bova JG, Kenworthy PR, Wise HA 2nd, Smith S et al (1992) Computed tomography of primary transitional cell carcinoma of upper urinary tracts. Urology 40:71–75
Caoili EM, Cohan RH, Inampudi P, Ellis JH, Shah RB, Faerber GJ, Montie JE (2005) MDCT urography of upper tract urothelial neoplasms. AJR AmJ Reontgenol 184:1873–1881
Yousem DM, Gatewood OM, Goldman SM, Marshall FF (1988) Synchronous and metachronous transitional cell carcinoma of the urinary tract: prevalence, incidence, and radiographic detection. Radiology 167:613–618
Rimondini A, Morra A, Bertolotto M, Locatelli M, Pozzi Mucelli R (2001) Spiral-CT with multiplanar reconstructions (MPRS) in the evaluation of ureteral neoplasms: preliminary results. Radiol Med (Torino) 101:459–465
Caoili EM, Cohan RH, Korobkin M, Platt JF, Francis IR, Faerber GJ et al (2002) Urinary tract abnormalities: initial experience with multi-detector row CT urography. Radiology 222:353–560
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fritz, G.A., Schoellnast, H., Deutschmann, H.A. et al. Multiphasic multidetector-row CT (MDCT) in detection and staging of transitional cell carcinomas of the upper urinary tract. Eur Radiol 16, 1244–1252 (2006). https://doi.org/10.1007/s00330-005-0078-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-005-0078-0