Ellie Rose Lee MD, Presenter: Nothing to Disclose

Bryan Michael Hoag MD, Abstract Co-Author: Nothing to Disclose

Lauren Marie Brubaker Burke MD, Abstract Co-Author: Consultant, Amgen Inc

Julia R. Fielding MD, Abstract Co-Author: Nothing to Disclose

To identify upper tract tumors in those patients undergoing CT urography for hematuria and/or history of urothelial cancer.

The study was IRB approved and HIPAA compliant. A retrospective review was performed on 2054 adult patients (median age, 56 years; range 18-94 years) who underwent CT urography (CTU) examination at a single institution between October 2006 and October 2012 for evaluation of hematuria and/or history of urothelial cancer. Patients were identified via electronic medical records. A standardized multi-phase CT urography protocol was used over the six-year time frame which included 5 mm axial non-contrast, post-contrast, and delayed images through the kidneys and bladder and 3 mm coronal reformats in the delayed phase. All CT urograms were interpreted by radiologists specializing in abdominal imaging. The radiology reports were reviewed for urothelial lesions. The medical charts and pathologic results were reviewed for those patients with positive CT urograms.

Of the 2054 patients, 114 (5.6 %) were positive for pathology proven urothelial tract cancer on CT urography examination. 86 of the 2054 (4.2 %) patients had bladder masses on CTU, 25 of the 2054 (1.2%) patients had upper tract lesions on CTU, and 3 of the 2054 (0.2 %) patients had both upper tract and bladder lesions on CTU.

Upper tract urothelial cancers are extremely rare in a tertiary care institution. Only 1 % of the patients who underwent CT urograms for hematuria or for history of urothelial cancer were positive for upper tract disease. This should prompt reconsideration of indications for interval follow-up or surveillance with this high radiation dose exam.

CT urography for hematuria and/or history of urothelial cancer was positive in only 1% of patients, and interval surveillance intervals should be reconsidered to avoid unnecessary radiation exposure.

Lee, E, Hoag, B, Burke, L, Fielding, J, Upper Tract Urothelial Cancers Identified on CT Urography: A Six-year Review.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14004088.html