Editing AUA: Upper Tract Urothelial Carcinoma (2023) (section)

=== Imaging ===

* '''<span style="color:#ff0000">Cross-sectional imaging of the upper tract with contrast including delayed images</span>'''
** '''<span style="color:#ff0000">Preferred modality: multiphase computed tomography (CT) scan with excretory phase imaging of the urothelium</span>'''
*** Pooled sensitivity of 92%
*** Pooled specificity of 95%
** '''<span style="color:#ff0000">If contraindications to contrast-enhanced CT such as chronic kidney disease (CKD) (e.g. eGFR <30[https://medicine.yale.edu/diagnosticradiology/patientcare/policies/nephropathy/]) or untreatable allergy to iodinated contrast medium, use magnetic resonance (MR) urography</span>'''
*** MRI is less sensitive than CT, similar specificity
** '''If contraindications to multiphasic CT and MR urography, use retrograde pyelography in conjunction with non-contrast axial imaging (renal ultrasound) to assess the upper urinary tracts.'''
*PET scans
**Should not be obtained routinely 
**May be selectively considered for patients who are at risk for metastatic recurrence and are not able to have contrast enhanced CT and MRI
*Patients with findings suggestive of metastatic UTUC should be evaluated to define the extent of disease and referred to medical oncology for further management