The development of CT urography for investigating haematuria
<p>This thesis addresses the three principal questions concerning the development of CT urography for investigating haematuria and each question is the subject of a separate chapter. The questions are:</p> <p><ol><li>What is the reasoning behind using CT urography?</...
| Main Authors: | , |
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| Format: | Thesis |
| Language: | English |
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2013
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| _version_ | 1817932326082969600 |
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| author | Cowan, N N. C. Cowan |
| author2 | Harris, A |
| author_facet | Harris, A Cowan, N N. C. Cowan |
| author_sort | Cowan, N |
| collection | OXFORD |
| description | <p>This thesis addresses the three principal questions concerning the development of CT urography for investigating haematuria and each question is the subject of a separate chapter. The questions are:</p> <p><ol><li>What is the reasoning behind using CT urography?</li> <li>What is the optimum diagnostic strategy using CT urography?</li> <li>What are the problems with using CT urography and how may solutions be provided?</li></ol></p> <p>Haematuria can signify serious disease such as urinary tract stones, renal cell cancer, upper tract urothelial cancer (UTUC) and bladder cancer (BCa).</p> <p>CT urography is defined as contrast enhanced CT examination of kidneys, ureters and bladder. The technique used here includes unenhanced, nephrographic and excretory-phases for optimized diagnosis of stones, renal masses and urothelial cancer respectively.</p> <p>The reasoning behind using excretory-phase CT urography for investigating haematuria is based on results showing its high diagnostic accuracy for UTUC and BCa.</p> <p>Patients with haematuria are classified as low risk or high risk for UTUC and BCa, by a risk score, determined by the presence / absence of risk factors: age > 50 years, visible or nonvisible haematuria, history of smoking and occupational exposure.</p> <p>The optimum diagnostic strategy for patients at high risk for urothelial cancer, uses CT urography as a replacement test for ultrasonography and intravenous urography and as a triage test for flexible and rigid cystoscopy, resulting in earlier diagnosis and potentially improving prognosis. For patients at low risk, ultrasonography, unenhanced and nephrographic-phase CT urography are proposed as initial imaging tests.</p> <p>Problems with using CT urography include false positive results for UTUC, which are eliminated by retrograde ureteropyelography-guided biopsy, an innovative technique, for histopathological confirmation of diagnosis. Recommendations for the NHS and possible future developments are discussed.</p> <p>CT urography, including excretory-phase imaging, is recommended as the initial diagnostic imaging test before cystoscopy for patients with haematuria at high risk for urothelial cancer.</p> |
| first_indexed | 2024-03-06T20:03:51Z |
| format | Thesis |
| id | oxford-uuid:284084de-2a71-4e35-8342-41f039b03df1 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-12-09T03:36:08Z |
| publishDate | 2013 |
| record_format | dspace |
| spelling | oxford-uuid:284084de-2a71-4e35-8342-41f039b03df12024-12-01T19:42:41ZThe development of CT urography for investigating haematuriaThesishttp://purl.org/coar/resource_type/c_db06uuid:284084de-2a71-4e35-8342-41f039b03df1TumoursHaematuriaComputed tomography urographyMedical SciencesDiagnosisOncologyLife SciencesCancerUrologyEnglishOxford University Research Archive - Valet2013Cowan, NN. C. CowanHarris, A<p>This thesis addresses the three principal questions concerning the development of CT urography for investigating haematuria and each question is the subject of a separate chapter. The questions are:</p> <p><ol><li>What is the reasoning behind using CT urography?</li> <li>What is the optimum diagnostic strategy using CT urography?</li> <li>What are the problems with using CT urography and how may solutions be provided?</li></ol></p> <p>Haematuria can signify serious disease such as urinary tract stones, renal cell cancer, upper tract urothelial cancer (UTUC) and bladder cancer (BCa).</p> <p>CT urography is defined as contrast enhanced CT examination of kidneys, ureters and bladder. The technique used here includes unenhanced, nephrographic and excretory-phases for optimized diagnosis of stones, renal masses and urothelial cancer respectively.</p> <p>The reasoning behind using excretory-phase CT urography for investigating haematuria is based on results showing its high diagnostic accuracy for UTUC and BCa.</p> <p>Patients with haematuria are classified as low risk or high risk for UTUC and BCa, by a risk score, determined by the presence / absence of risk factors: age > 50 years, visible or nonvisible haematuria, history of smoking and occupational exposure.</p> <p>The optimum diagnostic strategy for patients at high risk for urothelial cancer, uses CT urography as a replacement test for ultrasonography and intravenous urography and as a triage test for flexible and rigid cystoscopy, resulting in earlier diagnosis and potentially improving prognosis. For patients at low risk, ultrasonography, unenhanced and nephrographic-phase CT urography are proposed as initial imaging tests.</p> <p>Problems with using CT urography include false positive results for UTUC, which are eliminated by retrograde ureteropyelography-guided biopsy, an innovative technique, for histopathological confirmation of diagnosis. Recommendations for the NHS and possible future developments are discussed.</p> <p>CT urography, including excretory-phase imaging, is recommended as the initial diagnostic imaging test before cystoscopy for patients with haematuria at high risk for urothelial cancer.</p> |
| spellingShingle | Tumours Haematuria Computed tomography urography Medical Sciences Diagnosis Oncology Life Sciences Cancer Urology Cowan, N N. C. Cowan The development of CT urography for investigating haematuria |
| title | The development of CT urography for investigating haematuria |
| title_full | The development of CT urography for investigating haematuria |
| title_fullStr | The development of CT urography for investigating haematuria |
| title_full_unstemmed | The development of CT urography for investigating haematuria |
| title_short | The development of CT urography for investigating haematuria |
| title_sort | development of ct urography for investigating haematuria |
| topic | Tumours Haematuria Computed tomography urography Medical Sciences Diagnosis Oncology Life Sciences Cancer Urology |
| work_keys_str_mv | AT cowann thedevelopmentofcturographyforinvestigatinghaematuria AT nccowan thedevelopmentofcturographyforinvestigatinghaematuria AT cowann developmentofcturographyforinvestigatinghaematuria AT nccowan developmentofcturographyforinvestigatinghaematuria |