CT urography: definition,indications and techniques. A guideline for clinical practice |
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Authors: | Aart?J?Van Der?Molen Nigel?C?Cowan Ullrich?G?Mueller-Lisse Claus?C?A?Nolte-Ernsting Satoru?Takahashi Richard?H?Cohan CT Urography Working Group of the European Society of Urogenital Radiology |
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Affiliation: | Department of Radiology C-2S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. molen@lumc.nl |
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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.
Electronic Supplementary Material The online version of this article (doi:) contains supplementary material, which is available to authorized users.
ESUR: |
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Keywords: | Tomography X-ray computed Urography Radiation dosage Practice guidelines |
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