Virtual endoscopy: Navigation within pelvicaliceal system

Purpose: To evaluate the use of virtual endoscopy (VE) for the investigation of the pelvicaliceal unit and the depiction of its anatomic deformities. Patients and Methods: Two study groups were prospectively enrolled in our protocol: ten patients with nonurologic pathologies, and thus without any known deformity of the pelvicaliceal unit (group A), and five patients with caliceal obstruction (group B). Virtual endoscopy represented a non-invasive technique providing amplification of the image in three-dimensional space. Results: Virtual endoscopy was feasible in all patients, and in all cases succeeded in demonstrating the three-dimensional morphology of the region of interest. The entire processing time ranged from 10 to 15 minutes (mean 12.6 minutes), and the three-dimensional image could be viewed from different angles, allowing better evaluation of the collecting system and its deformities than is possible with conventional intravenous urography or percutaneous nephrostomography. Conclusion: Virtual endoscopy enabled the creation of endoluminal views of the renal pelvis and calices from spiral tomographic images, thereby allowing diagnostic-preoperative and postoperative evaluation of the pelvicaliceal unit.