Investigators evaluate diagnostic tests for patients with microhematuria

Video

“These shortages and declines in supply have forced practitioners to readjust their diagnostic algorithms or at least question the usual practices,” says Jacob Taylor, MD, MPH.

In this video, Jacob Taylor, MD, MPH, describes the background behind the study, “Diagnostic Imaging in the Evaluation of Asymptomatic Microhematuria: Systematic Review and Meta-Analysis.” Taylor is a fellow in urologic oncology at the University of Texas Southwestern Medical Center in Dallas.

Transcription:

The impetus for this study was twofold. First, over the past year, as a result of the COVID-19 pandemic, many practitioners and providers across the country have seen limitations in the availability of iodinated contrast media, the main material in CT urography, which historically has been the gold standard for the work-up of urologic malignancy. These shortages and declines in supply have forced practitioners to readjust their diagnostic algorithms or at least question the usual practices. There are other good reasons to be good stewards of imaging including reducing radiation exposure, cost, and concern over potential renal toxicities. In 2020, the [American Urological Association] guidelines were updated, which encouraged the de-intensification of imaging for patients with microhematuria, particularly for low and intermediate risk. So it was really in this context that we wanted to evaluate the evidence behind these recommendation changes and what the diagnostic test accuracy was for not only CT urogram, but ultrasound and MRU as well in detecting upper tract urothelial carcinoma in patients specifically with microhematuria.

This transcription was edited for clarity.

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