CT urography: the end of IVU?

A review of the literature on the diagnostic accuracy of multidetector computed tomography urography (MDCTU) and intravenous urography (IVU) reveals a lack of comparative studies. However, the available data indicate that MDCTU has a high diagnostic accuracy. MDCTU is also preferred by patients, as it does not require bowel preparation. Full acceptance of this technique by the urologist will depend on optimisation of the communication process with a careful selection of the images to be transmitted. MDCTU has a higher cost than IVU but allows some diagnostic algorithms to be simplified. The real concern potentially limiting the widespread use of MDCTU is its higher radiation dose when compared with IVU. Although low-dose protocols will soon be available, a substantial dose reduction can already be achieved by tailoring MDCTU to the clinical problem rather than using a standardised approach. Our analysis indicates that IVU will definitely lose any residual role it may still have. In our department, the last urographic procedure was performed in May 2006.