title: Comprehensive MR Urography Protocol: Equally Good Diagnostic Performance and Enhanced Visibility of the Upper Urinary Tract Compared to Triple-Phase CT Urography.
abstract: OBJECTIVE
  To prospectively compare the diagnostic performance and the visualization of the upper urinary tract (UUT) using a comprehensive 3.0T- magnetic resonance urography (MRU) protocol versus triple-phase computed tomography urography (CTU).
  
  
  METHODS
  During the study period (January-2014 through December-2015), all consecutive patients in our tertiary university hospital scheduled by a urologist for CTU to exclude UUT malignancy were invited to participate. Diagnostic performance and visualization scores of 3.0T-MRU were compared to CTU using Wilcoxon matched-pairs test.
  
  
  RESULTS
  Twenty patients (39 UUT excreting units) were evaluated. 3.0T-MRU and CTU achieved equal diagnostic performances. The benign etiology of seven UUT obstructions was clarified equally with both methods. Another two urinary tract malignant tumors and one benign extraurinary tumor were detected and confirmed. Diagnostic visualization was slightly better in the intrarenal cavity areas with CTU but worsened towards distal ureter. MRU showed consistently slightly better visualization of the ureter. In the comparison, full 100% visualizations were detected in all areas in 93.6% (with 3.0T-MRU) and 87.2% (with CTU) and >75% visualization in 100% (3.0T-MRU) and 93.6% (CTU). Mean CTU effective radiation dose was 9.2 mSv.
  
  
  CONCLUSIONS
  Comprehensive 3.0T-MRU is an accurate imaging modality achieving comparable performance with CTU; since it does not entail exposure to radiation, it has the potential to become the primary investigation technique in selected patients.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02606513.
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Mazen
authors.initials: M
authors.lastname: Sudah
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.|Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Amro
authors.initials: A
authors.lastname: Masarwah
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Sakari
authors.initials: S
authors.lastname: Kainulainen
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Marja
authors.initials: M
authors.lastname: Pitkänen
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Matikka
authors.affiliation: Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Vaiva
authors.initials: V
authors.lastname: Dabravolskaite
authors.affiliation: Department of Surgery, Urology Unit, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Sirpa
authors.initials: S
authors.lastname: Aaltomaa
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.|Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.|Biocenter Kuopio and Cancer Center of Eastern Finland, University of Eastern Finland, Kuopio, Finland.
authors.forename: Ritva
authors.initials: R
authors.lastname: Vanninen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014551:Urinary Tract / Q000000981:diagnostic imaging*; D014567:Urography / Q000379:methods*; D014571:Urologic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging