PURPOSE OF REVIEW: Upper tract urothelial carcinoma (UTUC) is a rare malignancy posing significant diagnostic and management challenges. This review provides an overview of the evidence supporting various imaging modalities and offers insights into future innovations in UTUC imaging. RECENT FINDINGS: With the growing use of advancements in computed tomography (CT) technologies for both staging and follow-up of UTUC patients, continuous innovations aim to enhance performance and minimize the risk of excessive exposure to ionizing radiation and iodinated contrast medium. In patients unable to undergo CT, magnetic resonance imaging serves as an alternative imaging modality, though its sensitivity is lower than CT. Positron emission tomography, particularly with innovative radiotracers and theranostics, has the potential to significantly advance precision medicine in UTUC. Endoscopic imaging techniques including advanced modalities seem to be promising in improved visualization and diagnostic accuracy, however, evidence remains scarce. Radiomics and radiogenomics present emerging tools for noninvasive tumor characterization and prognosis. SUMMARY: The landscape of imaging for UTUC is rapidly evolving, with significant advancements across various modalities promising improved diagnostic accuracy, patient outcomes, and safety.

• MeSH
• karcinom z přechodných buněk * diagnóza   diagnostické zobrazování   terapie   patologie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• nádory ledvin diagnostické zobrazování   terapie   diagnóza   patologie   MeSH
• nádory močovodu diagnostické zobrazování   diagnóza   terapie   patologie   MeSH
• počítačová rentgenová tomografie metody   MeSH
• pozitronová emisní tomografie metody   MeSH
• staging nádorů MeSH
• urologické nádory diagnóza   diagnostické zobrazování   terapie   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

• MeSH
• jazyk (prostředek komunikace) MeSH
• karcinom z přechodných buněk * diagnostické zobrazování   terapie   MeSH
• lidé MeSH
• nádory močového měchýře * diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• úvodníky MeSH
• Geografické názvy
• Švédsko MeSH

• Klíčová slova
• avelumab,
• MeSH
• antitumorózní látky * terapeutické užití   MeSH
• chronická lymfatická leukemie diagnóza   MeSH
• karcinom z přechodných buněk * chirurgie   diagnostické zobrazování   farmakoterapie   MeSH
• karcinom z renálních buněk diagnostické zobrazování   patologie   MeSH
• lidé MeSH
• nádory močového měchýře chirurgie   diagnóza   farmakoterapie   MeSH
• PET/CT MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• kazuistiky MeSH

PURPOSE OF REVIEW: To assess patterns of presentation, diagnostics and treatment in patients with upper tract urothelial carcinoma (UTUC), a multicentre registry was launched. Clinical data of UTUC patients were prospectively collected over a 5-year period. RECENT FINDINGS: Data from 2380 patients were included from 2014 to 2019 (101 centres in 29 countries). Patients were predominantly male (70.5%) and 53.3% were past or present smokers. The majority of patients (58.1%) were evaluated because of symptoms, mainly macroscopic hematuria. Computed tomography (CT) was the most common performed imaging modality (90.5%). A ureteroscopy (URS) was part of the diagnostic process in 1184 (49.7%) patients and 488 (20.5%) patients were treated endoscopically. In total, 1430 patients (60.1%) were treated by a radical nephroureterectomy, 59% without a prior diagnostic URS. Eighty-two patients (3.4%) underwent a segmental resection, 19 patients (0.8%) were treated by a percutaneous tumour resection. SUMMARY: Our data is in line with the known epidemiologic characteristics of UTUC. CT imaging is the preferred imaging modality as also recommended by guidelines. Diagnostic URS gained a stronger position, however, in almost half of patients a definitive treatment decision was made without complete endoscopic information. Only one-third of patients with UTUC are currently treated with kidney sparing surgery.

• MeSH
• karcinom z přechodných buněk * diagnostické zobrazování   epidemiologie   MeSH
• lidé MeSH
• nádory ledvin * chirurgie   MeSH
• nádory močovodu * diagnostické zobrazování   epidemiologie   MeSH
• nefroureterektomie MeSH
• registrace MeSH
• ureteroskopie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH

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.

• MeSH
• karcinom z přechodných buněk diagnostické zobrazování   MeSH
• lidé MeSH
• multidetektorová počítačová tomografie * MeSH
• nádory ledvin diagnostické zobrazování   MeSH
• nádory močovodu diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH

BACKGROUND/AIM: The aim of this study was to evaluate the possibility to discriminate the blood clot from tumorous tissue in the assessment of transitional cell carcinoma (TCC), when CT data are used only from single-phase dual-energy CT (DECT). MATERIALS AND METHODS: A total of 18 patients were included into the retrospective analysis of the prospectively collected data (the average age was 67.3 years, range=62-79 years, 12 males, 6 females). DECT was performed in all patients after intravenous administration of the iodinated contrast material. DECT analysis using three-material decomposition algorithm was used to discriminate blood and enhancing tumorous tissue. In all patients, TCC was detected and subsequently kidney surgery or endoscopy was performed within the next two weeks. The findings were compared with DECT results. RESULTS: In our cohort of patients we found 9 TCC of the renal pelvis or ureter and 7 TCC of the urinary bladder. The accuracy of the TCC detection was 94% (17/18). The presence of coagulated blood within the urinary collecting system together with a tumor was detected in 7 CT examinations. The blood coagulum without a confirmed malignant tumor was found in one case with false positive DECT finding. In other 6 cases bleeding was confirmed during surgery or endoscopy (accuracy 87%). CONCLUSION: The dual-energy data analysis enables discrimination of a blood clot from tumorous tissue. It helps in detection of UCC in cases when the excretion potential of the kidneys is decreased due to fulfillment of the collecting system with blood clots.

• MeSH
• algoritmy MeSH
• jod analýza   MeSH
• karcinom z přechodných buněk diagnóza   diagnostické zobrazování   patologie   MeSH
• kontrastní látky MeSH
• ledviny patologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• močový měchýř patologie   chirurgie   MeSH
• nádorové biomarkery analýza   MeSH
• počítačová rentgenová tomografie metody   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• trombóza diagnóza   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: Upper-tract urothelial carcinoma (UTUC) is a relatively uncommon disease with limited available evidence on specific topics. The purpose of this article was to review the previous literature to summarize the current knowledge about UTUC epidemiology, diagnosis, preoperative evaluation and prognostic assessment. METHODS: Using MEDLINE, a non-systematic review was performed including articles between January 2000 and February 2016. English language original articles, reviews and editorials were selected based on their clinical relevance. RESULTS: UTUC accounts for 5-10 % of all urothelial cancers, with an increasing incidence. UTUC and bladder cancer share some common risk factors, even if they are two different entities regarding practical, biological and clinical characteristics. Aristolochic acid plays an important role in UTUC pathogenesis in certain regions. It is further estimated that approximately 10 % of UTUC are part of the hereditary non-polyposis colorectal cancer spectrum disease. UTUC diagnosis remains mainly based on imaging and endoscopy, but development of new technologies is rapidly changing the diagnosis algorithm. To help the decision-making process regarding surgical treatment, extent of lymphadenectomy and selection of neoadjuvant systemic therapies, predictive tools based on preoperative patient and tumor characteristics have been developed. CONCLUSIONS: Awareness regarding epidemiology, diagnosis, preoperative evaluation and prognostic assessment changes is essential to correctly diagnose and manage UTUC patients, thereby potentially improving their outcomes.

• MeSH
• dědičné nepolypózní kolorektální nádory epidemiologie   MeSH
• karcinom z přechodných buněk diagnostické zobrazování   epidemiologie   patologie   chirurgie   MeSH
• kyseliny aristolochové metabolismus   MeSH
• ledvinná pánvička diagnostické zobrazování   patologie   chirurgie   MeSH
• lidé MeSH
• lymfadenektomie MeSH
• nádory ledvin diagnostické zobrazování   epidemiologie   patologie   chirurgie   MeSH
• nádory močového měchýře epidemiologie   MeSH
• nádory močovodu diagnostické zobrazování   epidemiologie   patologie   chirurgie   MeSH
• neoadjuvantní terapie MeSH
• předoperační péče MeSH
• prognóza MeSH
• rizikové faktory MeSH
• ureteroskopie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Nález ložiska renálního parenchymu pomocí zobrazovací metody klade otázku, zda se jedná o ložisko benigní nebo maligní povahy a zda stačí ložisko sledovat, nebo dále pomocí intervence řešit. Následující přehledný článek stručně rekapituluje klasifikaci renálního ložiska, jeho diagnostiku a další doporučený postup.

After finding a renal parenchymal mass by an imaging method, we have to establish whether the mass is benign or malignant and decide whether it should be observed only or managed by intervention. This paper briefly summarizes classification, diagnostics and recommended treatment of renal masses.

• Klíčová slova
• renální ložisko, solidní ložisko,
• MeSH
• angiomyolipom diagnostické zobrazování   MeSH
• cystická onemocnění ledvin * diagnostické zobrazování   MeSH
• diferenciální diagnóza MeSH
• karcinom z přechodných buněk diagnostické zobrazování   MeSH
• karcinom z renálních buněk diagnostické zobrazování   MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nádory ledvin * diagnostické zobrazování   MeSH
• počítačová rentgenová tomografie MeSH
• ultrasonografie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH