{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:37:38Z","timestamp":1777509458055,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Acta Radiol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Standardized care pathway (SCP) for macrohematuria (patients aged \u226550 years) in Sweden includes four-phase computed tomography urography (CTU) before cystoscopy, but targeted SCP lead time for CTU (6 days)\/treatment is fulfilled in &lt;25% of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To retrospectively analyze the incidence of CTU-diagnosed upper urinary tract (UUT), kidney and bladder tumors, calculi, radiation dose, and its implications for SCP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>A total of 4491 consecutive CTU reports on macrohematuria indication were reviewed, mainly during 2022 (86.6%) from nine radiology units: four regions, three university hospitals, and two private units. Tumor findings were verified via biopsy\/cytology reports, CTU characteristics, and follow-up. Effective patient radiation doses were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In patients aged \u226550 years (n\u2009=\u20093915) the incidence of UUT\/kidney\/bladder tumors was 0.9%\/1.0%\/6.9%, respectively, and of calyceal, pelvic, ureteral, and bladder calculi was 13%, 2.0%, 2.7%, and 2.2%, respectively. Median effective dose was 12.9 mSv (range=10\u201322 mSv) in the six radiology units using four-phase CTU in 87%\u2013100% of the examinations and 9\u201312 mSv in the three units using four-phase in 3%\u201353%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The limited incidence of UUT and kidney tumors diagnosed at CTU for macrohematuria necessitates a multidisciplinary discussion on how to improve SCP lead times for the vast majority with urothelial tumors, i.e. bladder tumors. Alternative diagnostic pathways such as cystoscopy and clinical risk evaluation before CTU should be contemplated. Additionally, there is a need to optimize radiation dose by reducing the number of CTU phases on one hand and without losing significant diagnostic accuracy on the other hand.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02841851251387444","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T17:52:07Z","timestamp":1766080327000},"page":"227-236","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Computed tomography urography in macroscopic hematuria: a retrospective study with implications for standard care pathway"],"prefix":"10.1177","volume":"67","author":[{"given":"Johan","family":"Jendeberg","sequence":"first","affiliation":[{"name":"Department of Radiology, Faculty of Medicine and Health, \u00d6rebro University, \u00d6rebro, 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Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Meurling","sequence":"additional","affiliation":[{"name":"Unilabs AB"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6263-4293","authenticated-orcid":false,"given":"Christian","family":"Papatziamos Hjelle","sequence":"additional","affiliation":[{"name":"Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Sj\u00f6gren","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Physics, \u00d6rebro University Hospital, \u00d6rebro, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodica","family":"Tila","sequence":"additional","affiliation":[{"name":"Link\u00f6ping 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