Urothelial carcinoma of the upper urinary tract (UUT) is a relatively uncommon genitourinary malignancy, accounting for about 5-7% of urothelial tumors. The significant features of this tumor are multifocality and high rate of recurrence. Computed tomography urography (CTU) has replaced excretory urography (EU) and retrograde pyelography (RP) for imaging of upper tract urothelial carcinoma. While many studies have confirmed high sensitivity (88-100%) and specificity (93-100%) of CTU, an optimized CT protocol is of critical importance in screening, staging, and post-operative follow-up of patients (Chlapoutakis, Eur J Radiol 73(2):334-338, 2010; Caoli and Cohan, Abdom Radiol (NY) 41(6):1100-1107, 2016). The key element of the CT protocol is to have adequate distension of the collecting system with excreted contrast, to detect subtle lesions at an early stage. In this article, we discuss the background of upper urinary tract TTC, pathogenesis, CT protocol and the role of imaging in evaluation of this malignancy, staging, as well as different imaging appearances.
Abdominal radiology (New York). 2019 Aug 22 [Epub ahead of print]
Osama Ali, Elliot Fishman, Sheila Sheth
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Johns Hopkins University, 601 N. Caroline Street/JHOC 3235A, Baltimore, MD, 21287, USA. ., Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Johns Hopkins University, 601 N. Caroline Street/JHOC 3235A, Baltimore, MD, 21287, USA.