Gadolinium Enhanced Magnetic Resonance Urography for Upper Urinary Tract Malignancy

Naoki Takahashi, James F. Glockner, Robert P. Hartman, Bernard F. King, Bradley C. Leibovich, David W. Stanley, Patrick D. Fitz-Gibbon, Akira Kawashima

Research output: Contribution to journalArticlepeer-review

62 Scopus citations


Purpose: We retrospectively evaluated the accuracy of gadolinium enhanced magnetic resonance urography to detect upper urinary tract tumors. Materials and Methods: A total of 91 magnetic resonance urography studies for suspected upper tract malignancy were done in 70 males and 18 females with a mean age of 71.7 years. Breath hold coronal T2-weighted single shot fast spin-echo and breath-hold coronal 3-dimensional T1-weighted spoiled gradient-recalled echo images with fat suppression were obtained during the nephrographic and excretory phases after intravenous injection of gadolinium based contrast material. Two radiologists independently reviewed magnetic resonance images for a tumor by 4 regions (right/left and renal collecting system/ureter). Sensitivity, specificity and accuracy were calculated. Results: A total of 35 urinary tract regions in 18 males and 7 females with a mean age of 70.4 years were confirmed to have an upper tract malignant tumor and 219 urinary tract regions were confirmed to be tumor-free. Sensitivity, specificity and accuracy to detect upper urinary tract malignancy were 74.3%, 96.8% and 93.7% for reviewer 1, and 62.9%, 96.3% and 91.7% for reviewer 2, respectively. When patients with a ureteral stent or nephrostomy tube were excluded from analysis, sensitivity, specificity and accuracy were 86.2%, 99.5% and 97.7% for reviewer 1, and 72.4%, 97.9% and 94.6% for reviewer 2, respectively. Conclusions: Gadolinium enhanced magnetic resonance urography is accurate to detect upper urinary tract malignant tumors.

Original languageEnglish (US)
Pages (from-to)1330-1336
Number of pages7
JournalJournal of Urology
Issue number4
StatePublished - Apr 2010


  • carcinoma
  • contrast media
  • diagnosis
  • magnetic resonance imaging
  • urinary tract

ASJC Scopus subject areas

  • Urology


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