Have an account? Please log in.
Text size: Small font Default font Larger font
.
Radiology Daily
Radiology Daily PracticalReviews.com Radiology Daily

Multi-Detector Row CT During Portal Venous Phase Holds Promise

January 4, 2008
Written by: , Filed in: Abdominal Imaging
  • Comments
.

A recent study was conducted to assess the accuracy of multi-detector row CT performed during the portal venous phase in evaluating for possible bladder lesions in patients with painless gross hematuria and recurrent microscopic hematuria.

The results have shown that multi-detector row CT during the portal venous phase can be highly accurate in the detection of bladder lesions in patients with hematuria.

Participants
In this prospective analysis, 118 patients were included; exclusion criteria were transurethral resection of bladder tumor prior to CT examination, urolithiasis, renal parenchymal neoplasm, renal parenchymal disease, and cystoscopy contraindication.

Methodology
The 118 patients were split into 2 groups composed of 28 patients who had undergone cystoscopy before CT and 90 patients who had undergone CT before cystoscopy.

The interval between multi-detector row CT and cystoscopy ranged from 0 to 29 days.

At cystoscopy, bladder lesions were considered present when papillary or sessile bladder wall lesions, bladder mucosa color change, or ulcerative bladder lesions were observed.

CT examinations were performed with a 16-section multi-detector unit.

Bladder distention was achieved by not having the patient void for at least 1.5 hours before the examination.

The hematuria protocol included unenhanced, corticomedullary phase, portal venous phase, and early excretory phase images. On the unenhanced images, bladder distention was felt to be adequate when the bladder was spherical in shape and had a minimum diameter >8 cm.

The portal venous phase for the bladder was acquired at the 70-second scanning delay.

Two genitourinary radiologists reviewed all images. Bladder lesions were felt to be present when there was either a protruding hyperenhanced lesion or hyperenhanced wall thickening.

Related CME:
NEW FOR 2009
Abdominal & Thoracic CT/MR/US: Optimizing Practice
The University of California, San Francisco School of Medicine
Evolving technology improves radiological practice through improved image quality for anatomical interpretation and generation of functional data. The use of MDCT and fast, multi-phase imaging sequences also translates to a tremendous increase in data that requires review and handling and greater need for contrast and radiation safety awareness. This activity targets the community radiologist involved in body and cardiovascular imaging with a focus on developing an efficient workflow practice in the modern imaging environment.
Read more or order: Abdominal & Thoracic CT/MR/US: Optimizing Practice

CT/MRI of the Abdomen and Pelvis
University of California San Francisco Department of Radiology and Biomedical Imaging
Provides an updated review on the use of helical (single and multidetector-row) CT and MRI for imaging of the abdomen and pelvis. Participants will learn the current approach and uses of CT/MRI in the examination of the abdomen and pelvis including advances in abdominal MRI techniques, genitourinary applications of CT/MRI, CT colonoscopy, CT/MR angiography, and CT cholangiography.
Earn up to 12 AMA PRA Category 1 Credits™.
Abdominal Imaging CME

Results
Agreement between CT image interpretation and cystoscopic findings was 92% (first reviewer) and 87% (second reviewer). There was a 90% agreement on the number of lesions found by both reviewers. Sensitivity was 89% and 92% and specificity was 88% and 97% for the 2 reviewers. Six lesions were overlooked by both reviewers due to a maximum diameter of <=10 mm or of 15 to 20 mm, obscured by metallic streak artifact, and bladder base location presumed to be part of the prostate. Conclusions
Multi-detector row CT during the portal venous phase can be highly accurate in bladder lesion detection in patients with hematuria.

Reviewer’s Comments
These results demonstrate a high per lesion detection sensitivity and specificity. Multi-detector row CT during the portal venous phase is accurate and holds promise as an initial bladder examination in patients with painless gross hematuria and patients with recurrent microscopic hematuria.

A limitation noted in this study was that the scan delay was fixed at 70 seconds in all patients. Consequently, this might have been suboptimal in some of the patients, such as those with underlying cardiac dysfunction.

Author: John C. Sabatino,

Reference:
Park SB, Kim JK, et al.Hematuria: Portal Venous Phase Multi-Detector Row CT of the Bladder–A Prospective Study.
Radiology; 2007; 245 (December): 798-805

Related CME:
NEW FOR 2009
Abdominal & Thoracic CT/MR/US: Optimizing Practice
The University of California, San Francisco School of Medicine
Evolving technology improves radiological practice through improved image quality for anatomical interpretation and generation of functional data. The use of MDCT and fast, multi-phase imaging sequences also translates to a tremendous increase in data that requires review and handling and greater need for contrast and radiation safety awareness. This activity targets the community radiologist involved in body and cardiovascular imaging with a focus on developing an efficient workflow practice in the modern imaging environment.
Read more or order: Abdominal & Thoracic CT/MR/US: Optimizing Practice

CT/MRI of the Abdomen and Pelvis
University of California San Francisco Department of Radiology and Biomedical Imaging
Provides an updated review on the use of helical (single and multidetector-row) CT and MRI for imaging of the abdomen and pelvis. Participants will learn the current approach and uses of CT/MRI in the examination of the abdomen and pelvis including advances in abdominal MRI techniques, genitourinary applications of CT/MRI, CT colonoscopy, CT/MR angiography, and CT cholangiography.
Earn up to 12 AMA PRA Category 1 Credits™.
Abdominal Imaging CME
.
  • Comments
.

Would you like to keep current with radiological news and information?

Post Your Comments and Responses

Comments are closed.