European Radiology

, 18:4 | Cite as

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

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


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.


Tomography X-ray computed Urography Radiation dosage Practice guidelines 

Supplementary material

330_2007_792_MOESM1_ESM.pdf (1.2 mb)
Electronic Supplementary Material (PDF 1.2 MB)


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Copyright information

© European Society of Radiology 2007

Authors and Affiliations

  • Aart J. Van Der Molen
    • 1
  • Nigel C. Cowan
    • 2
  • Ullrich G. Mueller-Lisse
    • 3
  • Claus C. A. Nolte-Ernsting
    • 4
  • Satoru Takahashi
    • 5
  • Richard H. Cohan
    • 6
  • CT Urography Working Group of the European Society of Urogenital Radiology (ESUR)
  1. 1.Department of Radiology C-2SLeiden University Medical CenterLeidenThe Netherlands
  2. 2.Department of RadiologyThe Churchill HospitalOxfordUK
  3. 3.Department of Clinical RadiologyUniversity of Munich Hospitals - InnenstadtMunichGermany
  4. 4.Department of Diagnostic and Interventional RadiologyUniversity Hospital Hamburg-EppendorfHamburgGermany
  5. 5.Department of Radiology HP 212Radboud University Medical CenterNijmegenThe Netherlands
  6. 6.Department of RadiologyUniversity of Michigan Health SystemAnn ArborUSA

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