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ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 4  |  Page : 356-361

The accuracy of computed tomography in the diagnosis of upper urinary tract urothelial carcinoma in correlation with the final histopathology: A retrospective study in 275 patients at a Tertiary Urology Institute


1 Department of Radiology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
2 Urology Department, Sohar Hospital, Ministry of Health, Sohar, Oman
3 Urology Department, Faculty of Medicine, Kafr El-Sheikh University, Kafr El-Sheikh, Egypt
4 Department of Pathology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
5 Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt

Correspondence Address:
Dr. Mohamed Mohamed Elawdy
Department of Urology, Ministry of Health, Sohar Hospital, Sohar
Oman
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DOI: 10.4103/UA.UA_32_20

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Introduction: Because the reports in the literature of radiologic investigations for upper tract urothelial cancer (UTUC) are limited by the number of patients, and included patients with different pathologies, we aimed to study the overall accuracy of computed tomography (CT) in the diagnosis of UTUC and their accuracy on predicting tumor location. Methods: A retrospective review from 1990 to 2017 included patients who were treated for UTUC. Unenhanced CT scan was obtained first using Multi-Detector Computed Tomography (MDCT, Philips Medical Systems), then nonionic contrast medium, containing 350 mg iodine /ml was injected at 4 mL/s. Analysis was performed using SPSS®. Results: Of 275 patients, complete data on CT was available on 270 (98%) patients. CT reported only two false positive and six false negative results and the overall accuracy was 96-97%. In comparison to the final pathological reports, CT /CTU detected 85% of the tumor location of in the renal pelvic and 50% of the calyceal tumors. In ureteric tumors, they detected distal (66/71= 93%) more than proximal ureteric tumors (60%). Conclusion: In our cohort, CT/ CTU has a high overall accuracy (97%) in diagnosing UTUC, capability to well visualize tumors of distal ureter and renal pelvis, but could miss calyceal tumors. The matter to rely only on CT without ureteroscopic biopsy in the diagnosis of UTUC especially if radical surgery is planned needs further prospective studies.


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