CT urography: definition, indications and techniques. A guideline for clinical practice.

Abstract:

:The aim was to develop clinical guidelines for multidetector computed tomography urography (CTU) by a group of experts from the European Society of Urogenital Radiology (ESUR). Peer-reviewed papers and reviews were systematically scrutinized. A summary document was produced and discussed at the ESUR 2006 and ECR 2007 meetings with the goal to reach consensus. True evidence-based guidelines could not be formulated, but expert guidelines on indications and CTU examination technique were produced. CTU is justified as a first-line test for patients with macroscopic haematuria, at high-risk for urothelial cancer. Otherwise, CTU may be used as a problem-solving examination. A differential approach using a one-, two- or three-phase protocol is proposed, whereby the clinical indication and the patient population will determine which CTU protocol is employed. Either a combined nephrographic-excretory phase following a split-bolus intravenous injection of contrast medium, or separate nephrographic and excretory phases following a single-bolus injection can be used. Lower dose (CTDIvol 5-6 mGy) is used for benign conditions and normal dose (CTDIvol 9-12 mGy) for potential malignant disease. A low-dose (CTDIvol 2-3 mGy) unenhanced series can be added on indication. The expert-based CTU guidelines provide recommendations to optimize techniques and to unify the radiologist's approach to CTU.

journal_name

Eur Radiol

journal_title

European radiology

authors

Van Der Molen AJ,Cowan NC,Mueller-Lisse UG,Nolte-Ernsting CC,Takahashi S,Cohan RH,CT Urography Working Group of the European Society of Urogenital Radiology (ESUR).

doi

10.1007/s00330-007-0792-x

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

4-17

issue

1

eissn

0938-7994

issn

1432-1084

journal_volume

18

pub_type

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