Imaging features of helical computed tomography suggesting advanced urothelial carcinoma arising from the pelvocalyceal system.
BACKGROUND
Urothelial carcinoma is the most common malignant tumor arising from the pelvocalyceal system. Helical computed tomography (CT) is probably the best preoperative-stage modality for the determination of treatment plan and prognosis.


OBJECTIVE
To obtain helical CT imaging features suggesting advanced pelvocalyceal urothelial carcinoma.


METHODS
Preoperative CT images in 44 patients with pelvocalyceal urothelial carcinoma were retrospectively reviewed and correlated with the pathological examination to determine imaging features suggesting stage III or IV of the disease.


RESULTS
Pathological stages revealed stage I in 16, stage II in three, stage III in 17, and stage IV in eight patients. Seven patients had metastatic lymph nodes. CT imaging showed that renal parenchymal invasion, sinus fat invasion, and lymph node metastasis were highly suggestive of advanced urothelial cell carcinoma (P<0.05). Helical CT sensitivity, specificity, and accuracy for advanced pelvocalyceal urothelial carcinoma were 76% (19/25), 84% (16/19), and 80% (35/44), respectively.


CONCLUSIONS
Preoperative helical CT may suggest imaging features of advanced urothelial carcinoma, influencing treatment plan and patient prognosis, even though its accuracy is not so high.
Kwak
Kyung Won
KW
Department of Urology, Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Park
Byung Kwan
BK
Kim
Chan Kyo
CK
Lee
Hyun Moo
HM
Choi
Han Yong
HY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007479:Iopamidol; D007670:Kidney Calices / Q000473:pathology*; D007682:Kidney Pelvis / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods*; D014571:Urologic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D019459:Urothelium / Q000000981:diagnostic imaging* / Q000473:pathology
D003287:Contrast Media; D007479:Iopamidol