Split-bolus CT urogram: Is less more?

Based on this study, SB-CTU without special maneuvers for ureteral distention is highly sensitive for detecting upper tract UCA, although with a low positive predictive value, false positives do occur. The clinical utility of increasing accuracy in diagnosing this low-prevalence disease through other more complex CT urogram protocols should be weighed against the added cost and radiation dose associated with these protocols.