OBJECTIVES: To determine conventional computed tomography (CT) signs in the diagnosis and staging of upper urinary tract tumors (UUTTs). METHODS: Retrospective study was made of the CTs of 82 patients diagnosed with UUTTs. Nine CT signs were defined and compared with the pathology of the surgical specimen. A chi2 test was used for statistical analyses. RESULTS: We reviewed the CTs of 93 UUTTs in 82 patients, of which 36% were invasive and 12% had positive lymph nodes. Renal parenchymal invasion was found in 82% of high-grade and in 18% of low-grade tumors (p = 0.001). 94% of the tumors with signs of renal parenchymal invasion were invasive (p < 0.001), as well as 88% of those appearing as renal masses (p = 0.005), with a global sensitivity of 64% and specificity of 97%. The CT sensitivity and specificity of detecting infiltration of the ureter was 67 and 77%, respectively, and no sign was statistically significant. The detection of lymph node involvement had a sensitivity of 87.5% and a specificity of 98%. CONCLUSIONS: CT offers good sensitivity (87.5%) and specificity (98%) in the detection of lymph node involvement, and 64% sensitivity and 97% specificity for the detection of renal tumor invasion.
OBJECTIVES: To determine conventional computed tomography (CT) signs in the diagnosis and staging of upper urinary tract tumors (UUTTs). METHODS: Retrospective study was made of the CTs of 82 patients diagnosed with UUTTs. Nine CT signs were defined and compared with the pathology of the surgical specimen. A chi2 test was used for statistical analyses. RESULTS: We reviewed the CTs of 93 UUTTs in 82 patients, of which 36% were invasive and 12% had positive lymph nodes. Renal parenchymal invasion was found in 82% of high-grade and in 18% of low-grade tumors (p = 0.001). 94% of the tumors with signs of renal parenchymal invasion were invasive (p < 0.001), as well as 88% of those appearing as renal masses (p = 0.005), with a global sensitivity of 64% and specificity of 97%. The CT sensitivity and specificity of detecting infiltration of the ureter was 67 and 77%, respectively, and no sign was statistically significant. The detection of lymph node involvement had a sensitivity of 87.5% and a specificity of 98%. CONCLUSIONS: CT offers good sensitivity (87.5%) and specificity (98%) in the detection of lymph node involvement, and 64% sensitivity and 97% specificity for the detection of renal tumor invasion.
Authors: Francesco Soria; Shahrokh F Shariat; Seth P Lerner; Hans-Martin Fritsche; Michael Rink; Wassim Kassouf; Philippe E Spiess; Yair Lotan; Dingwei Ye; Mario I Fernández; Eiji Kikuchi; Daher C Chade; Marko Babjuk; Arthur P Grollman; George N Thalmann Journal: World J Urol Date: 2016-09-07 Impact factor: 4.226