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Erschienen in: World Journal of Urology 5/2020

18.07.2019 | Original Article

Diagnostic performance of multidetector computed tomographic (MDCTU) in upper tract urothelial carcinoma (UTUC): a systematic review and meta-analysis

verfasst von: Florian Janisch, Shahrokh F. Shariat, Pascal Baltzer, Harun Fajkovic, Shoji Kimura, Takehiro Iwata, Philipp Korn, Lin Yang, Petr V. Glybochko, Michael Rink, Mohammad Abufaraj

Erschienen in: World Journal of Urology | Ausgabe 5/2020

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Abstract

Purpose

To systematically review the literature evaluating the performance of MDCTU for the diagnosis of UTUC and meta-analyse available data. We also compared the diagnostic accuracy of MDCTU to other radiologic modalities.

Methods

This systematic review and meta-analysis was conducted according to the PRISMA statement. A systematic research using Pubmed, Scopus, Cochrane, and Web of Science libraries was performed on November 1st, 2018. We included all original articles investigating the performance of MDCTU for the diagnosis of UTUC using histopathology as the reference standard for true positives and an unsuspicious clinical follow-up of at least 1 year for true negatives.

Results

Overall, 13 studies comprising 1233 patients were eligible and included in this systematic review and meta-analysis. In patient-based analyses, the pooled sensitivity and specificity were 92% (CI 0.85–0.96) and 95% (CI 0.88–0.98), respectively. The reported sensitivity in the per-lesion analysis ranged between 91 and 97%. All studies reporting segment-based analysis demonstrated high diagnostic accuracy (> 90%). While one study reported higher accuracy of retrograde ureteropyelography than MDCTU (97% vs. 94%), another study demonstrated an inferior accuracy of intravenous pyelogram compared to MDCTU. Findings on the accuracy of diffusion-weighted magnetic resonance imaging compared to MDCTU were inconsistent.

Conclusion

MDCTU has excellent diagnostic performance in detecting UTUC and ruling-out suspicious upper urinary tract lesions in per-patient and per-lesion-based analyses. We confirm the choice of MDCTU as the radiologic diagnostic modality of choice for work-up of suspicious upper urinary tract lesions providing valuable information in patient counseling, decision-making, and treatment planning.
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Literatur
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Metadaten
Titel
Diagnostic performance of multidetector computed tomographic (MDCTU) in upper tract urothelial carcinoma (UTUC): a systematic review and meta-analysis
verfasst von
Florian Janisch
Shahrokh F. Shariat
Pascal Baltzer
Harun Fajkovic
Shoji Kimura
Takehiro Iwata
Philipp Korn
Lin Yang
Petr V. Glybochko
Michael Rink
Mohammad Abufaraj
Publikationsdatum
18.07.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 5/2020
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-019-02875-8

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