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CT urography: definition, indications and techniques. A guideline for clinical practice

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Abstract

The aim was to develop clinical guidelines for multidetector computed tomography urography (CTU) by a group of experts from the European Society of Urogenital Radiology (ESUR). Peer-reviewed papers and reviews were systematically scrutinized. A summary document was produced and discussed at the ESUR 2006 and ECR 2007 meetings with the goal to reach consensus. True evidence-based guidelines could not be formulated, but expert guidelines on indications and CTU examination technique were produced. CTU is justified as a first-line test for patients with macroscopic haematuria, at high-risk for urothelial cancer. Otherwise, CTU may be used as a problem-solving examination. A differential approach using a one-, two- or three-phase protocol is proposed, whereby the clinical indication and the patient population will determine which CTU protocol is employed. Either a combined nephrographic-excretory phase following a split-bolus intravenous injection of contrast medium, or separate nephrographic and excretory phases following a single-bolus injection can be used. Lower dose (CTDIvol 5–6 mGy) is used for benign conditions and normal dose (CTDIvol 9–12 mGy) for potential malignant disease. A low-dose (CTDIvol 2–3 mGy) unenhanced series can be added on indication. The expert-based CTU guidelines provide recommendations to optimize techniques and to unify the radiologist’s approach to CTU.

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Authors and Affiliations

  1. Department of Radiology C-2S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands

    Aart J. Van Der Molen

  2. Department of Radiology, The Churchill Hospital, Oxford, OX3 7LJ, UK

    Nigel C. Cowan

  3. Department of Clinical Radiology, University of Munich Hospitals - Innenstadt, Ziemssenstraße 1, 80336, Munich, Germany

    Ullrich G. Mueller-Lisse

  4. Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    Claus C. A. Nolte-Ernsting

  5. Department of Radiology HP 212, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands

    Satoru Takahashi

  6. Department of Radiology, University of Michigan Health System, B1-132 Taubman Center 0302, 1500 E Medical Center Dr., Ann Arbor, MI, 48109-0302, USA

    Richard H. Cohan

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  1. Aart J. Van Der Molen
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  2. Nigel C. Cowan
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  3. Ullrich G. Mueller-Lisse
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  4. Claus C. A. Nolte-Ernsting
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  5. Satoru Takahashi
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  6. Richard H. Cohan
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CT Urography Working Group of the European Society of Urogenital Radiology (ESUR)

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Correspondence to Aart J. Van Der Molen.

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Van Der Molen, A.J., Cowan, N.C., Mueller-Lisse, U.G. et al. CT urography: definition, indications and techniques. A guideline for clinical practice. Eur Radiol 18, 4–17 (2008). https://doi.org/10.1007/s00330-007-0792-x

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  • DOI: https://doi.org/10.1007/s00330-007-0792-x

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