Detection of upper tract urothelial neoplasms: sensitivity of axial, coronal reformatted, and curved-planar reformatted image-types utilizing 16-row multi-detector CT urography.
BACKGROUND
The purpose of our study was to determine the sensitivity of 16-row multi-detector computed tomography urography (CTU) axial, coronal reformatted, and curved-planar reformatted image-types for upper tract urothelial neoplasm detection.


METHODS
Twenty-one CTU examinations were identified that contained one or more pathology-proven upper tract urothelial neoplasms during our study period. Two readers independently reviewed 1.25 and 2.5 mm axial, coronal reformatted, and curved-planar reformatted excretory phase CTU images. Each reader then documented the location and appearance of lesions suspicious for upper tract urothelial neoplasm. These results were correlated with relevant endoscopic/surgical procedure notes as well as pathology results.


RESULTS
Reader #1 detected 72%, 63%, 75%, and 72% of the known 32 upper tract urothelial neoplasms using 1.25 mm axial, 2.5 mm axial, coronal reformatted, and curved-planar reformatted image-types, respectively. Reader #2 detected 72% of the known neoplasms using each of the four image-types. No significant difference in sensitivity between image-types was identified. After combining the results for all four image-types, readers #1 and #2 had overall sensitivities of 94% and 91%.


CONCLUSIONS
Axial, coronal reformatted, and curved-planar reformatted image-types have similar sensitivities for the detection of upper tract urothelial neoplasm in 16-row multi-detector CTU. Reviewing multiple image-types increases the sensitivity of urothelial lesion detection.
Dillman
Jonathan R
JR
Department of Radiology, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5030, USA. jonadill@med.umich.edu
Caoili
Elaine M
EM
Cohan
Richard H
RH
Ellis
James H
JH
Francis
Isaac R
IR
Schipper
Matthew J
MJ
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D015331:Cohort Studies; D003287:Contrast Media; D004724:Endoscopy; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014571:Urologic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D019459:Urothelium / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide