title: Gadolinium enhanced magnetic resonance urography for upper urinary tract malignancy.
abstract: OBJECTIVE
  We retrospectively evaluated the accuracy of gadolinium enhanced magnetic resonance urography to detect upper urinary tract tumors.
  
  
  METHODS
  A total of 91 magnetic resonance urography studies for suspected upper tract malignancy were done in 70 males and 18 females with a mean age of 71.7 years. Breath hold coronal T2-weighted single shot fast spin-echo and breath-hold coronal 3-dimensional T1-weighted spoiled gradient-recalled echo images with fat suppression were obtained during the nephrographic and excretory phases after intravenous injection of gadolinium based contrast material. Two radiologists independently reviewed magnetic resonance images for a tumor by 4 regions (right/left and renal collecting system/ureter). Sensitivity, specificity and accuracy were calculated.
  
  
  RESULTS
  A total of 35 urinary tract regions in 18 males and 7 females with a mean age of 70.4 years were confirmed to have an upper tract malignant tumor and 219 urinary tract regions were confirmed to be tumor-free. Sensitivity, specificity and accuracy to detect upper urinary tract malignancy were 74.3%, 96.8% and 93.7% for reviewer 1, and 62.9%, 96.3% and 91.7% for reviewer 2, respectively. When patients with a ureteral stent or nephrostomy tube were excluded from analysis, sensitivity, specificity and accuracy were 86.2%, 99.5% and 97.7% for reviewer 1, and 72.4%, 97.9% and 94.6% for reviewer 2, respectively.
  
  
  CONCLUSIONS
  Gadolinium enhanced magnetic resonance urography is accurate to detect upper urinary tract malignant tumors.
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA. takahashi.naoki@mayo.edu
authors.forename: Naoki
authors.initials: N
authors.lastname: Takahashi
authors.forename: James F
authors.initials: JF
authors.lastname: Glockner
authors.forename: Robert P
authors.initials: RP
authors.lastname: Hartman
authors.forename: Bernard F
authors.initials: BF
authors.lastname: King
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Leibovich
authors.forename: David W
authors.initials: DW
authors.lastname: Stanley
authors.forename: Patrick D
authors.initials: PD
authors.lastname: Fitz-Gibbon
authors.forename: Akira
authors.initials: A
authors.lastname: Kawashima
mesh_terms: D000368:Aged; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement; D007680:Kidney Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014516:Ureteral Neoplasms / Q000175:diagnosis*; D014567:Urography / Q000379:methods
chemical_list: D003287:Contrast Media; D005682:Gadolinium