Imaging for upper tract urothelial carcinoma: update of the evidence and a glimpse into the future.

Ekaterina Laukhtina, Shahrokh F Shariat, Dina Muin

Journal: Current opinion in urology 2024;35(1):103-107

PMID: 39444272

Abstract

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.

Address: Department of Urology, Comprehensive Cancer Center, Medical University of Vienna.; Department of Biomedical Imaging and Image-guided Therapy, Devision of Nuclear Medicine, Medical University of Vienna.; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna.; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.; Department of Urology, Weill Cornell Medical College, New York, New York.; Department of Urology, University of Texas Southwestern, Dallas, Texas, USA.; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.; Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan.

DOI: 10.1097/MOU.0000000000001241

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MeSH Terms: Humans, Carcinoma, Transitional Cell, Tomography, X-Ray Computed, Magnetic Resonance Imaging, Ureteral Neoplasms, Positron-Emission Tomography, Kidney Neoplasms, Neoplasm Staging, Urologic Neoplasms