Virtual Ureteroscopy of Upper Tract Urothelial Tumors
Imaging plays a crucial role in the evaluation of urinary tract pathology. Technologic advancements in computing and imaging technology have revolutionized the role in which radiology plays in the workup of patients with hematuria. CT and MR have replaced conventional intravenous pyelography (IVP) in the imaging workup for abnormalities of the urinary collecting system. Both methods have their relative advantages and disadvantages, however both can elegantly and noninvasively diagnose disease with high sensitivity and specificity. Emerging techniques, such as ‘Virtual’ Ureteroscopy with both CT and MR are going to play an expanding part in the workup of neoplastic urinary tract pathology. Utilizing dedicated 3D software, virtual ureteroscopy makes it possible to manipulate the imaging dataset obtained from CT or MR to allow for intraluminal visualization of renal collecting system, ureters, and bladder. This can provide a noninvasive way to diagnose even small lesions of the urinary tract, or offer a road map for treatment or interventions.
KeywordsRadiology Computed tomography/CT Magnetic resonance imaging/MRI Virtual ureteroscopy Virtual cystoscopy
- 8.Latchamsetty KC, Porter CR. Treatment of upper tract urothelial carcinoma: a review of surgical and adjuvant therapy. Rev Urol. 2006. 8(2):61–70. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1578534&tool=pmcentrez&rendertype=abstract.
- 15.Davenport MS, Khalatbari S, Cohan RH, Dillman JR, Myles JD, Ellis JH. Contrast material-induced nephrotoxicity and intravenous low-osmolality iodinated contrast material: risk stratification by using estimated glomerular filtration rate. Radiology. 2013;268(3):719–28. doi: 10.1148/radiol.13122276.CrossRefPubMedGoogle Scholar
- 16.Chlapoutakis K, Theocharopoulos N, Yarmenitis S, Damilakis J. Performance of computed tomographic urography in diagnosis of upper urinary tract urothelial carcinoma, in patients presenting with hematuria: systematic review and meta-analysis. Eur J Radiol. 2010;73(2):334–8. doi: 10.1016/j.ejrad.2008.10.026.CrossRefPubMedGoogle Scholar
- 20.Yuh BI, Cohan RH. Different phases of renal enhancement: role in detecting and characterizing renal masses during helical CT. 1999;(Sept):747–55.Google Scholar
- 28.Kekelidze M, Dwarkasing RS, Dijkshoorn ML, Sikorska K, Verhagen PCMS, Krestin GP. Kidney and urinary tract imaging: triple-bolus multidetector CT urography as a one-stop shop-protocol design, opacification, and image quality analysis. Radiology. 2010;255(2):508–16. doi: 10.1590/S1677-55382010000400019.CrossRefPubMedGoogle Scholar
- 35.Neri E, Boraschi P, Caramella D, et al. MR virtual endoscopy of the upper urinary tract. Am J Roentgenol. 2000;175(6):1697–702. http://www.scopus.com/inward/record.url?eid=2-s2.0-0033654115&partnerID=40&md5=4d77f6f06410ff7c0c330b19b3dfd232.CrossRefPubMedGoogle Scholar
- 36.Mueller-Lisse UG, Mueller-Lisse UL, Hinterberger J, Schneede P, Meindl T, Reiser MF. Multidetector-row computed tomography (MDCT) in patients with a history of previous urothelial cancer or painless macroscopic haematuria. Eur Radiol. 2007;17(11):2794–803. doi: 10.1007/s00330-007-0609-y.CrossRefPubMedGoogle Scholar