Abstract
Purpose
To assess the diagnostic yield of a computed tomography urography (CTU) study in patients less than 50 years of age, who have a history of military service, and who are at increased risk of urological cancers secondary to harmful practices and work-related exposures.
Methods
137 Consecutive patients who underwent CTU between 2012 and 2013 for new onset of hematuria were included. Initial review of the clinical interpretations of the CTU studies grouped the studies into negative and positive exams for any urological findings. Review of the patients’ medical records and subsequent radiology studies determined microscopic versus gross hematuria at presentation and any findings after their CTU study consistent with a urological malignancy. The positive exams were reviewed by second readers, blinded to the clinical interpretation of the initial CTU studies, who first read the unenhanced images. The readers characterized findings as visible on non-contrast CT alone or they requested contrast-enhanced images. Each urological finding was recorded for each patient.
Results
Of the 137 included patients, 84 had micro-hematuria and 53 had gross hematuria. There were a total of 99 negative examinations of the 137 included patients. Contrast was requested 14 times to confirm 11 benign cysts. No findings concerning for malignancy were found by the readers or on subsequent record reviews for each patient.
Conclusion
An unenhanced CT may be appropriate to evaluate new onset microscopic, and possibly gross hematuria, in patients younger than 40, even in patients at increased risk of urologic cancer.
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The views expressed in this presentation are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the US Government.
The author(s) are military service members. This work was prepared as part of official duties. Title 17 U.S.C. 105 provides that ‘Copyright protection’ under this title is not available for any work of the US Government.
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Mace, L.R., Galloway, T.L., Ma, A. et al. Diagnostic yield of CT urography in the evaluation of hematuria in young patients in a military population. Abdom Radiol 42, 1906–1910 (2017). https://doi.org/10.1007/s00261-017-1084-9
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DOI: https://doi.org/10.1007/s00261-017-1084-9