Diagnostic accuracy of ultrasound and X-ray kub in ureteric colic taking CT as gold standard

The objective of the study was to compare the sensitivity and specificity of ultrasound, X-ray KUB and CT for the diagnosis of ureteral colic in patients with acute flank pain. This study was carried out in Department of Radiology Sindh Institute of Urology and Transplantation [SIUT] from Aug 2010 to Nov 2010. A total of 190 patients with mean age of 35 years were included in the study. All individuals underwent pre procedural imaging X-ray KUB, U/S and CT. On these imaging modalities obstruction of urinary tract and stones were determined. X-ray KUB was done as a guide for U/S exam only. Ureteral stones were confirmed in 190 patients. Specificity for ct was 100% whereas X-ray KUB and U/S was 94% and 76% respectively. Sensitivity for CT 100%, U/S 52.6% and X-ray KUB 89.5% respectively. Some stones were not detected by U/S and few stones were not detected on X-ray KUB due to bowel gases. Cases were correctly diagnosed with all three techniques. CT is the most reliable technique for the detection of uretric stones however, X-ray and U/S also be chosen alternative to CT with a reduce radiation dose

Diagnostic accuracy of MRI in differentiating non-muscle invasive from muscle invasive bladder carcinoma taking histopathological staging as a standard

To Determine Diagnostic accuracy Of MRI in differentiating non-muscle invasive from muscle invasive bladder carcinoma taking Histopathological staging as a standard. The data of 53 patients with bladder tumor who previously confirmed by cystoscopy were examined at 1.5 T, images were obtained and analyzed by radiologist without knowledge of the tumor stage. T2-weighted spin-echo or turbo-spin-echo, and dynamic Ti-weighted fast gradient-echo sequences were used. Histopathological grading served as standard of reference. Compared with the results submitted from the histopathology unit and using more detailed TNM classification, the sensitivity, specificity, and percent accuracy of MRI was 91%, 86%, 85% respectively. This data confirms the under-staging of the bladder tumor invasion done histopathologically while MR is a promising, non-invasive technique for the detection of bladder lesions with a high diagnostic performance

Primitive neuroectodermal tumor/Ewing's sarcoma in adult uro-oncology: a case series from a developing country

Peripheral primitive neuroectodermal tumor/Ewing's sarcoma [PNET/EWS] is primarily a tumor of soft tissues and bones. Primary localization of PNET/EWS in genitourinary organs is rare. No data on this localization of PNET/EWS are available in literature from Pakistan. We searched our adult uro-oncology records from 1994 till date and identified all cases of adult genitourinary and adrenal PNET/EWS diagnosed on histology and immunohistochemistry. Their case records were reviewed to obtain data on demographics, presentation, pathologic features, management and outcome. Six cases were found; all were young and had aggressive disease at presentation. Four had renal PNET/EWS. One case each of prostate and adrenal PNET/EWS was seen. Surgery and chemotherapy formed the mainstay of management. Three patients [50%] died during treatment, two were lost to follow-up and one case with renal PNET/EWS showed good initial response to chemotherapy but was later on lost to follow-up. In conclusion, PNET/EWS should be considered in the differential diagnosis of genitourinary malignant tumors in young patients. These tumors are aggressive with poor outcome