title: Diagnostic yield of CT urography in the evaluation of hematuria in young patients in a military population.
abstract: To assess the diagnostic yield of a computed tomography urography (CTU) study in patients less than 50 years of age, who have a history of military service, and who are at increased risk of urological cancers secondary to harmful practices and work-related exposures.
  
  
  
  137 Consecutive patients who underwent CTU between 2012 and 2013 for new onset of hematuria were included. Initial review of the clinical interpretations of the CTU studies grouped the studies into negative and positive exams for any urological findings. Review of the patients' medical records and subsequent radiology studies determined microscopic versus gross hematuria at presentation and any findings after their CTU study consistent with a urological malignancy. The positive exams were reviewed by second readers, blinded to the clinical interpretation of the initial CTU studies, who first read the unenhanced images. The readers characterized findings as visible on non-contrast CT alone or they requested contrast-enhanced images. Each urological finding was recorded for each patient.
  
  
  
  Of the 137 included patients, 84 had micro-hematuria and 53 had gross hematuria. There were a total of 99 negative examinations of the 137 included patients. Contrast was requested 14 times to confirm 11 benign cysts. No findings concerning for malignancy were found by the readers or on subsequent record reviews for each patient.
  
  
  
  An unenhanced CT may be appropriate to evaluate new onset microscopic, and possibly gross hematuria, in patients younger than 40, even in patients at increased risk of urologic cancer.
authors.affiliation: Department of Radiology, Naval Medical Center San Diego, 34800 Bob Wilson Dr. Ste. 204, San Diego, CA, 92134, USA.
authors.forename: Laura R
authors.initials: LR
authors.lastname: Mace
authors.affiliation: Department of Radiology, Naval Medical Center San Diego, 34800 Bob Wilson Dr. Ste. 204, San Diego, CA, 92134, USA.
authors.forename: Terrel L
authors.initials: TL
authors.lastname: Galloway
authors.affiliation: Department of Radiology, Naval Medical Center San Diego, 34800 Bob Wilson Dr. Ste. 204, San Diego, CA, 92134, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Ma
authors.affiliation: Department of Radiology, Naval Medical Center San Diego, 34800 Bob Wilson Dr. Ste. 204, San Diego, CA, 92134, USA.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Montgomery
authors.affiliation: Department of Radiology, Naval Medical Center San Diego, 34800 Bob Wilson Dr. Ste. 204, San Diego, CA, 92134, USA.
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Rockhill
authors.affiliation: Department of Radiology, Naval Medical Center San Diego, 34800 Bob Wilson Dr. Ste. 204, San Diego, CA, 92134, USA.
authors.forename: William W
authors.initials: WW
authors.lastname: Reynolds
authors.affiliation: Department of Radiology, Naval Medical Center San Diego, 34800 Bob Wilson Dr. Ste. 204, San Diego, CA, 92134, USA. robert.m.marks.mil@mail.mil.|Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD, 20814, USA. robert.m.marks.mil@mail.mil.
authors.forename: Robert M
authors.identifier: 0000-0002-1463-718X
authors.initials: RM
authors.lastname: Marks
mesh_terms: D000328:Adult; D003287:Contrast Media; D005260:Female; D006417:Hematuria / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D016273:Occupational Exposure / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014567:Urography
chemical_list: D003287:Contrast Media
keywords: CT urography; Hematuria; Military; Young adults