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The Radiology of Upper Tract Collecting System Neoplasms

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Urothelial Malignancies of the Upper Urinary Tract

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Abstract

While excretory pyelography, ultrasound, PET-CT, and MRI all have roles in the assessment of upper tract neoplasms, the workhouse is the CT. Ultrasound allows for dynamic assessment of masses and PET-CT allows for assessment of metabolic activity which allows for neoplasms to be detected in what would be otherwise normal appearing lymph nodes. MRI urography can be useful but is limited by expense, length of exam, and interpretative expertise. In CT, both pre- and post-contrast imaging is needed. Split bolus techniques have allowed for the reduction of radiation. The examination can be tailored to optimally opacify the collecting system to allow for detection of filling defects. It also permits for accurate assessment of extrarenal extension of disease. Appearance of the neoplasm can be varied that include mural and polypoid and often have an irregular surface. Not only can the masses be seen but also the effect on surrounding structures causing obstructions. A wide range of non-neoplastic conditions can have a similar appearance but will present with a different clinical picture. Close collaboration between the radiologist and urologist is therefore required.

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Authors and Affiliations

  1. Department of Radiology, Columbia University Medical Center, 185 Fort Washington Avenue, New York, NY, 10032, USA

    Stuart Bentley-Hibbert & Jeffrey H. Newhouse

Authors
  1. Stuart Bentley-Hibbert
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  2. Jeffrey H. Newhouse
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Correspondence to Stuart Bentley-Hibbert .

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Editors and Affiliations

  1. Chief, Section of Endourology and Minimally Invasive Urology, Westchester Medical Health Network, Valhalla, New York, USA

    Majid Eshghi

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Bentley-Hibbert, S., Newhouse, J.H. (2018). The Radiology of Upper Tract Collecting System Neoplasms. In: Eshghi, M. (eds) Urothelial Malignancies of the Upper Urinary Tract. Springer, Cham. https://doi.org/10.1007/978-3-319-51263-1_4

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  • DOI: https://doi.org/10.1007/978-3-319-51263-1_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-51261-7

  • Online ISBN: 978-3-319-51263-1

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