A review of the literature on the diagnostic accuracy of multidetector computed tomography
urography (MDCTU) and intravenous urography (IVU) reveals a lack of comparative studies.
However, the available data indicate that MDCTU has a high diagnostic accuracy. MDCTU
is also preferred by patients, as it does not require bowel preparation. Full acceptance
of this technique by the urologist will depend on optimisation of the communication
process with a careful selection of the images to be transmitted. MDCTU has a higher
cost than IVU but allows some diagnostic algorithms to be simplified. The real concern
potentially limiting the widespread use of MDCTU is its higher radiation dose when
compared with IVU. Although low-dose protocols will soon be available, a substantial
dose reduction can already be achieved by tailoring MDCTU to the clinical problem
rather than using a standardised approach. Our analysis indicates that IVU will definitely
lose any residual role it may still have. In our department, the last urographic procedure
was performed in May 2006.
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© 2009 Published by Elsevier Inc.
