title: Tumor characteristics of urothelial carcinoma on multidetector computerized tomography urography.
abstract: OBJECTIVE
  We investigated the relationship between tumor characteristics of urothelial carcinoma and detectability on multidetector computerized tomography urography.
  
  
  METHODS
  We retrospectively reviewed all adult consecutive patients with hematuria who underwent multidetector computerized tomography urography during a 23-month period at our hospital. Patients with a final diagnosis of urothelial carcinoma verified by histological examination of surgical specimens were included in the study. The presence and location of urothelial carcinomas on multidetector computerized tomography urography without knowledge of final diagnosis were recorded. Tumor characteristics (location, size, histological classification and stage) were recorded based mainly on histological findings. The association between tumor characteristics and urothelial carcinoma detectability on multidetector computerized tomography urography was analyzed.
  
  
  RESULTS
  A total of 70 patients who underwent multidetector computerized tomography urography had 87 verified urothelial carcinomas. Of these carcinomas 6 (6.9%) were undetectable by multidetector computerized tomography urography, including 5 ureteral and 1 bladder urothelial carcinoma. Size of detectable and nondetectable tumors on multidetector computerized tomography urography differed significantly (3.05 +/- 1.79 vs 0.65 +/- 0.99 cm, respectively, p = 0.001). Tumor location (p = 0.009), tumor size 1 cm or larger (p = 0.003) and noncarcinoma in situ tumors (p = 0.001) were significantly associated with multidetector computerized tomography urography detectability. Conversely organ confined disease had no association with multidetector computerized tomography urography detectability. Multivariate analyses showed that noncarcinoma in situ tumor was a significant predictor of multidetector computerized tomography urography detectability (p = 0.001).
  
  
  CONCLUSIONS
  Multidetector computerized tomography urography is useful for detecting nearly all urothelial carcinomas in adults with hematuria. Careful assessment by multidetector computerized tomography urography is needed to detect small (less than 1 cm) or ureteral urothelial carcinomas. It remains a challenge to detect carcinoma in situ tumors by multidetector computerized tomography urography. Thus, negative results of urothelial carcinomas on multidetector computerized tomography urography do not exclude the presence of carcinoma in situ tumors.
authors.affiliation: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China. lijenwang0918@gmail.com
authors.forename: Li-Jen
authors.initials: LJ
authors.lastname: Wang
authors.forename: Yon-Cheong
authors.initials: YC
authors.lastname: Wong
authors.forename: Kwai-Fong
authors.initials: KF
authors.lastname: Ng
authors.forename: Cheng-Keng
authors.initials: CK
authors.lastname: Chuang
authors.forename: Shen-Yang
authors.initials: SY
authors.lastname: Lee
authors.forename: Yung-Liang
authors.initials: YL
authors.lastname: Wan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014516:Ureteral Neoplasms / Q000000981:diagnostic imaging*; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging*; D014567:Urography / Q000379:methods