MP05-06 UTILITY OF RETROGRADE PYELOGRAM IN THE SETTING OF NON DIAGNOSTIC VISUALIZATION ON CT UROGRAM

You have accessJournal of UrologyImaging/Radiology: Uroradiology I1 Apr 2016MP05-06 UTILITY OF RETROGRADE PYELOGRAM IN THE SETTING OF NON DIAGNOSTIC VISUALIZATION ON CT UROGRAM Abdo Kabarriti, Robert Kovell, Shailen Sehgal, Christopher Miller, Thomas Guzzo, and Phillip Mucksavage Abdo KabarritiAbdo Kabarriti More articles by this author , Robert KovellRobert Kovell More articles by this author , Shailen SehgalShailen Sehgal More articles by this author , Christopher MillerChristopher Miller More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , and Phillip MucksavagePhillip Mucksavage More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1983AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES CT Urography (CTU) is one of the most commonly used imaging modality for upper tract imaging on work up of gross/microscopic hematuria and surveillance of transitional cell carcinoma (TCC) due to its high sensitivity and specificity. In up to 24% of cases, CTU may be equivocal such as when portions of ureters or collecting system are incompletely opacified. No clear consensus exists on whether such a finding should prompt further diagnostic studies. We sought to evaluate the utility of retrograde pyelography (RPG) after non-diagnostic visualization (NDV) on CTU. METHODS A retrospective review was performed of patients who underwent RPG for NDV on CTU that was obtained for either work-up for hematuria or surveillance of TCC. All RPG imaging was reviewed by a dedicated GU radiologist. Patient demographics, imaging modality prompting retrograde pyelography, finding on imaging modality, urinary cytology, presence or absence of hematuria, and retrograde or ureteroscopic results were recorded. RESULTS There were a total of 232 collecting systems/ureters evaluated via RPG for indeterminate urothelial imaging. Of these, 135 (58.2%) had a history of TCC, while 97 (41.8%) had a CT urography as part of the hematuria workup. Overall, no abnormalities were seen on RPG in 228 (97%) upper tract systems. In patients without a history of TCC, 96(99%) RPGs showed no evidence of upper tract lesions, and 1 (1%) had a non-diagnostic RPG. Follow-up ureteroscopy showed no evidence of upper tract lesion in the non-diagnostic case. In patients with a history of TCC, 132 (97.8%) RPGs showed no evidence of upper tract lesions, and 3 (2.2%) were non-diagnostic. Follow-up ureteroscopy showed no evidence of upper tract lesions in all 3 non-diagnostic cases. CONCLUSIONS The next step after non diagnostic upper tract imaging remains controversial. Based on our data, it appears safe for urologists faced with this clinical dilemma to omit a RPG, especially in patients without a previous history of TCC. Further larger prospective studies and analysis still need to be done in patients at increased risk for upper tract TCC. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e39 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Abdo Kabarriti More articles by this author Robert Kovell More articles by this author Shailen Sehgal More articles by this author Christopher Miller More articles by this author Thomas Guzzo More articles by this author Phillip Mucksavage More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...