title: Multidetector computed tomography urography for diagnosing upper urinary tract urothelial tumour.
abstract: OBJECTIVE
  To evaluate multidetector computed tomography urography (MDCTU) for diagnosing upper urinary tract (UUT) urothelial tumour by comparison with retrograde ureteropyelography (RUP).
  
  
  METHODS
  MDCTU and RUP were used in a selected series of adult patients presenting with haematuria. Entry criteria were based on findings on intravenous urography and were chosen to ensure a high prevalence of UUT urothelial tumour to allow a valid retrospective comparison of the diagnostic techniques. MDCTU and RUP studies were scored for the presence and absence of UUT urothelial tumour by two radiologists, retrospectively and independently, and while unaware of the demographic and clinical information. The reference standards were the histopathology and clinical follow-up.
  
  
  RESULTS
  MDCTU and RUP were used in 106 patients over a 24-month period. RUP was attempted in 151 of 212 UUTs; the corresponding MDCTU for each UUT was reviewed. MDCTU was a true-positive (TP) for urothelial tumour in 31, true-negative (TN) in 111, false-positive (FP) in eight and false-negative (FN) in one UUT, giving a sensitivity of 0.97, a specificity of 0.93, a positive predictive value (PPV) of 0.79 and a negative PV (NPV) of 0.99. RUP was technically successful and diagnostic in 96% of the UUTs (143/151). For diagnosing urothelial tumour, RUP was TP in 26, TN in 112, FP in four and FN in one UUT, giving a sensitivity of 0.97, specificity of 0.93, a PPV of 0.79 and NPV of 0.99.
  
  
  CONCLUSIONS
  This study validates quantitatively the use of MDCTU for diagnosing UUT urothelial tumour.
authors.affiliation: Department of Radiology, The Churchill Hospital, Oxford, UK. nigel.cowan@nds.ox.ac.uk
authors.forename: Nigel C
authors.initials: NC
authors.lastname: Cowan
authors.forename: Ben W
authors.initials: BW
authors.lastname: Turney
authors.forename: Nia J
authors.initials: NJ
authors.lastname: Taylor
authors.forename: Catherine L
authors.initials: CL
authors.lastname: McCarthy
authors.forename: Jeremy P
authors.initials: JP
authors.lastname: Crew
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000000981:diagnostic imaging*; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012015:Reference Standards; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000592:standards*; D014571:Urologic Neoplasms / Q000000981:diagnostic imaging*