Studies on imaging modality in cases of primary renal pelvic and ureteral carcinoma

50 patients treated during 1978-1986 at our department were evaluated for the purpose of studying the usefulness of several imaging modalities : excretory urography, retrograde pyelography, computed tomography, ultrasonic tomography, and arteriography, for the diagnosis of primary renal pelvic or ureteral tumors. The patients ranged in age from 43 to 83 years old (average : 65 years old). There were 41 males and 9 females. The affected side was the right in 22 cases and the left in 28 cases. Retrograde pyelography (RP) was found to be the most useful modality, followed by computed tomography (CT), ultrasonic tomography (US) and arteriography (AG), in those patients with renal pelvic tumors. RP and CT were also effective diagnostic imagings in those patients with ureteral tumors. Excretory urography (IVP) showed abnormal findings : non-visualized kidney, hydronephrosis, filling defects etc. in all cases. So, IVP was thought to be an effective screening method in the diagnosis of renal pelvic and ureteral tumors. There was no statistical correlation between IVP findings and stage in renal pelvic tumors. As for staging diagnosis, CT and AG were effective in those patients with renal pelvic tumors. Correct diagnosis was usually made by only two imaging modalities (IVP and RP). But CT and US were helpful for making a final diagnosis when RP could not be performed, and CT or AG was helpful in the staging diagnosis. Cytological study is necessary and should be added to imaging modalities to make a correct diagnosis, because its positive rates in the diagnosis of urothelial tumors are high. (author)