A Brief History of Radiological Imaging and Its Application in Urology

Abstract

Soon after X-rays were discovered by Wilhelm Roentgen in 1895, abdominal plain films were used to evaluate the kidneys, ureters and bladder. Eventually, contrast was used to further delineate structures and cross sectional imaging techniques were refined. Genitourinary imaging became more specific and integral in surgical planning and monitoring response to treatment. Before these advanced techniques, invasive procedures were often required to confirm the suspected diagnosis as imaging findings often relied on secondary signs. Today there is a wide selection of imaging modalities and protocols that are optimized for the detection of specific urologic conditions, ranging from diagnosing adrenal myelolipomas to staging testicular cancer. Imaging techniques have progressed to include both anatomic and functional imaging such as PET-CT as well as biomarkers which can help predict a patient’s response to treatment. Uroradiology crosses all imaging modalities including radiography, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine. Given the broad range of conditions and modalities, this chapter will focus on the brief history of uroradiology with regards to three common urologic conditions: renal cell carcinoma, urolithiasis, and urothelial carcinoma.