Imaging in Upper Tract Urothelial Carcinoma: A Review

SIMPLE SUMMARY: Urothelial carcinoma, a cancer of the urinary tract, is relatively common in the urinary bladder, termed the lower urinary tract. However, it is much less common in the upper urinary tract, which consists of the pelvicalyceal system and ureters. Medical imaging plays an important role in detection, diagnosis, and treatment planning of this uncommon disease. We aim to review the imaging methods currently available and future directions in the field of radiology to aid clinicians in treatment planning. ABSTRACT: Medical imaging is a critical tool in the detection, staging, and treatment planning of upper urinary tract urothelial carcinoma (UTUC). This article reviews the strengths and weaknesses of the different imaging techniques and modalities available clinically. This includes multidetector computed tomography (CT), multiparametric magnetic resonance imaging (MRI), ultrasound (US), and positron emission tomography (PET) for the detection, staging, and management of UTUC. In addition, we review the imaging techniques that are being developed and are on the horizon but have not yet made it to clinical practice. Firstly, we review the imaging findings of primary UTUC and the techniques across multiple modalities. We then discuss imaging findings of metastatic disease. Lastly, we describe the role of imaging in the surveillance after resection of primary UTUC based upon current guidelines.