Richard H. Cohan MD, Presenter: Consultant, General Electric Company Research funded, General Electric Company

1) Review the latest developments in CT urography. 2) Review currently accepted three-phase, two-phase, and one-phase protocols for producing an optimal quality CT urogram. 2) Discuss an approach allowing for detection of many calculi in enhanced urine will be described. 3) The CT urographic appearance of upper tract urothelial neoplasms will be reviewed. 4) Controversies concerning CT urographic imaging of the bladder will be discussed, including limitations in tumor detection in patients with previously treated superficial bladder cancers. 5) Indications and relative contraindications for CT urography will be enumerated.

CT urography (CTU) has all but replaced intravenous urography (IVU) as the imaging test of choice for evaluation of adults with many suspected urinary tract disorders. However, along with the emergence of this study, have come a number of new controversies. First, there is a difference of opinion concerning the indications for this study. Second, there is continuing debate concerning the optimal technique for performing CTU. Third, while it is widely accepted that CTU detects many more urothelial neoplasms than does IVU, some urinary tract neoplasms still escape detection, especially those located in the bladder. Fourth, increasing utilization has the potential of exposing both younger and older patients to a relatively radiation intense study and of leading to a decline in the frequency of positive diagnoses. Finally, most employed CTU techniques generate large numbers of images that can be both time-consuming and take great effort to review. In this innovative course, leading international experts on CTU will address and debate these issues. The course will be interspersed with scientific presentations revealing the results of the most recent CTU research studies . By the conclusion of the course, the attendee will have been informed of the latest opinions on how and when to perform and when not to perform CTU. and on how to maximize detection urothelial neoplasms in the upper tracts and in the bladder. The attendee will also be knowledgeable about the now better understood limitations of this technique.

Cohan, R, Genitourinary Series: CT Urography—State of the Art 2009.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8001545.html