Computerized tomographic ureteroscopy for diagnosing ureteral tumors

Purpose: Helical computerized tomography (CT) image acquisition has led to the availability of improved data sets for CT endoscopic imaging that repre sent virtual endoscopy using CT. We assessed the usefulness of CT ureterosc opic imaging for diagnosing ureteral tumors. Materials and Methods: A total of 16 patients with ureteral stenosis underw ent; surface rendering CT ureteroscopy after the intravenous administration of contrast material and furosemide. To distinguish ureteral tumors from u reteral strictures 2 observers blinded to other patient history and evaluat ion data independently and prospectively evaluated CT ureteroscopy with ref ormatted CT ureterograms in these 16 patients. CT ureteroscopic images were then correlated with surgical and pathological findings, which served as t he gold standard. Results: Surgical and pathological findings in the 16 patients revealed 16 ureteral tumors, including carcinoma in 10 (carcinoma in situ in 1, fibroep ithelial polyps in 2 and hyperplastic polypoids in 4), inflammatory intrins ic stricture in 2 and extrinsic stricture in 4 caused by retroperitoneal fi brosis in 2 and lymph node metastasis in 2. CT ureteroscopy correctly detec ted all lesions except 1 carcinoma in situ, 1 polypoid carcinoma and 1 hype rplastic polypoid. The sensitivity and specificity of CT ureteroscopy for d etecting ureteral tumors and carcinoma were 81% and 100%, and 80% and 75%, respectively, when tumors without stalks were considered carcinoma. Conclusions: CT ureteroscopy is useful for visualizing the complex morpholo gy of ureteral tumors and distinguishing tumor from ureteral stricture.