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Evaluation of the risks and benefits of CT urography for assessment of gross hematuria

Urology Jul 03, 2019

Yecies T, et al. - A PUBMED-based literature search was conducted and estimates of radiation-induced malignancy rates were gathered by the researchers in order to illustrate the risk of radiation-induced malignancy from CT Urography (CTU) in assessment of gross hematuria and compared this with the benefits of urinary tract cancer detection when contrasted with renal ultrasound. An association of male gender and age over 50 years with a corresponding risk of upper tract malignancy was observed. The risk of upper tract malignancy missed by renal ultrasound varied from 0.055% to 0.51% in females under 50 and in males over 50, respectively. Also, the risk of CTU-induced malignancy with related loss of life expectancy ranged from 0.25% and 0.027 years to 0.08% and 0.0054 years in females under 50 and in males over 50, respectively. An undetected upper tract malignancy would bear a loss of life expectancy of 49.2 years in females under 50, 13.4 years in males under 50, 2.6 years in females over 50, and 1.1 years in males over 50, for CTU to be higher to renal ultrasound. Hence, CTU for investigation of gross hematuria may bear a marked risk of radiation-induced secondary malignancy relative to the diagnostic advantage offered over renal ultrasound, in low-risk patients.
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