Diagnostic Performance of Low-Dose CT for the Detection of Urolithiasis: A Meta-Analysis

Niemann, Tilo; Kollmann, Thilo; Bongartz, Georg

doi:10.2214/ajr.07.3414

Cited by 257 publications

(150 citation statements)

References 49 publications

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“…It is well known that CT, which was used in the present study to evaluate the success rate, is more sensitive for detecting renal stones than both US and plain radiography (96.6%, 45% and 44-77%, respectively). [17][18][19] Furthermore, the previous study used fragmentation and stone extraction with basket forceps, which we could not perform in our study because of lack of equipment.…”

Section: Discussionmentioning

confidence: 99%

Flouroscopy-free technique is safe and feasible in retrograde intrarenal surgery for renal stones

Çimen

Halis

Sağlam

et al. 2017

Turkish Journal of Urology

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Objective: The aim of this study was to present outcomes of our patients who had undergone retrograde intrarenal surgery (RIRS) with fluoroscopy-free technique and evaluate the efficacy and safety of the technique. Material and methods:Between January 2013 and June 2015 the outcomes of 93 patients who had undergone RIRS with fluoroscopy-free technique were retrospectively evaluated. Our RIRS technique involved preoperative assessment of ureter by semi-rigid ureteroscope, inserting guidewire through semi-rigid ureteroscope, inserting ureteral access sheath over the guidewire with the visiual guidance of semi-rigid ureteroscope, passing flexible ureteroscope through the sheath, dusting the stone with holmium laser, rechecking the ureter with semirigid ureteroscope and inserting double J stent through semi-rigid ureteroscope. Low-dose computerized tomography scan was performed to all patients in postoperative first month and the results were classified as stone-free (absence of any fragment), clinically insignificant residual fragments (CIRF) (≤4 mm) and residual stone.Results: Study population consisted of 62 (66.6%) male and 31 (33.3%) female patients with a mean age of 47.8±14 (range 14-93) years. Mean stone size was 14.7±5 (7-32) mm. Median operative time was 72 (30-125) minutes. Stone-free rate was achieved in 65 (69.9%) patients while CIRF was achieved in 13 (13.9%) and residual stones were detected in 15 (16.1%) patients. Five patients (5.37%) had minor complications, including hematuria and fever. No major complications were observed. Conclusion:Fluoroscopy-free technique is effective and safe technique in management of renal stone. Furthermore fluoroscopy-free technique can protect the surgeon from the negative effects of radiation.Keywords: Flexible ureterorenoscopy; fluoroscopy; nephrolithiasis.Cite this article as: Çimen Hİ, Halis F, Sağlam HS, Gökçe A. Flouroscopy-free technique is safe and feasible in retrograde intrarenal surgery for renal stones. Turk J Urol 2017; 43: 309-12

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Section: Discussionmentioning

confidence: 99%

Flouroscopy-free technique is safe and feasible in retrograde intrarenal surgery for renal stones

Çimen

Halis

Sağlam

et al. 2017

Turkish Journal of Urology

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“…Since pelvic organs (bladder, colon and gonads) account for a considerable part of the effective dose and are close to the center of pelvis, the effective dose should be lower in obese patients than in underweight ones. Hence, an increase in effective tube current settings in patients with a high BMI may not result in a higher effective radiation dose [15,17,22]. In our study, the highest effective dose (9.5mSv) in the low dose protocol was seen in an obese patient who underwent examination with an effective tube current of 175 mAs.…”

Section: Discussionmentioning

confidence: 64%

Low Dose MDCT with Tube Current Modulation: Role in Detection of Urolithiasis and Patient Effective Dose Reduction

Koteshwar

Kakkar

Sripathi

et al. 2016

JCDR

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“…16,24,25 Lowdose unenhanced CT appears to have emerged as the imaging modality of choice given its very low radiation, diagnostic performance similar to that of regular-dose unenhanced CT, and significantly better diagnostic performance than KUB/ultrasonography. 17 Finally, although the population with the greatest concerns regarding radiation exposure is women, this also appears to be the population with the highest rate of alternative diagnosis. In our sample, 10% of women had an alternative diagnosis on low-dose unenhanced CT compared to 5% of men.…”

Section: Discussionmentioning

confidence: 99%

“…Low-dose CT has a radiation exposure that is slightly higher than that of KUB radiography and significantly less than that of IVP or regular-dose CT. 16 Its diagnostic performance has been found to be similar to that of regular unenhanced CT. 17 …”

Section: Ré Sumémentioning

confidence: 99%

Prevalence of alternative diagnoses in patients with suspected uncomplicated renal colic undergoing computed tomography: a prospective study

Pernet

Abergel

Parra

et al. 2015

CJEM

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Objectives: Unenhanced computed tomography (CT) has become a standard imaging technique for uncomplicated renal colic in many countries. The appropriate timing of CT imaging has not been established, and guidelines recommend that this imaging be performed between 1 and 7 days of presentation. The primary objective of this study was to determine the prevalence of alternative diagnosis identified with low-dose unenhanced CT in the emergency department (ED) in patients with suspected uncomplicated renal colic. Methods: This prospective single-centre study was carried out in a large university hospital ED. Over a 6-month period, all patients with clinically diagnosed renal colic and a plan to be discharged underwent low-dose unenhanced CT in the ED. Pregnant women, women of childbearing age not willing to have a pregnancy test, and patients who had already undergone diagnostic imaging were excluded. The primary outcome was the number and nature of the alternative diagnosis. Univariate analyses were performed to assess factors associated with the primary outcome. Results: A total of 178 patients were screened, and 155 underwent CT in the ED. The mean age was 42.2 years; 69% were male. The diagnosis of uncomplicated renal colic was confirmed in 118 participants (76%); 27 (17%) had an inconclusive CT scan. Overall, 10 patients (6%; 95% confidence interval [CI] 3-10) had an alternative diagnosis, 5 of whom were subsequently hospitalized. Conclusion: Low-dose unenhanced CT in the ED detects alternative diagnoses in 6% (95% CI 3-10) of patients with suspected uncomplicated renal colic, half of whom are subsequently hospitalized. Our prospective findings, which were similar to those reported in retrospective studies, are a potential argument for a systematic approach to ED imaging in suspected renal colic. Future research involving intervention and control groups would be helpful. RÉ SUMÉObjectif: La tomodensitomé trie (TDM) sans densification est devenue, dans de nombreux pays, une technique d'imagerie courante dans les cas de colique né phré tique sans complications. Toutefois, le moment propice pour faire passer cet examen n'est pas é tabli, et, d'aprè s les lignes directrices, l'examen devrait ê tre effectué entre le premier et le septiè me jour de la consultation. L'é tude avait pour objectif principal de dé terminer la pré valence d'autres diagnostics que celui de colique né phré tique sans complications, posé s dans des cas pré sumé s, à l'aide de la TDM sans densification à faible dose, au service des urgences (SU). Mé thode: Il s'agit d'une é tude prospective, unicentrique, qui a é té mené e dans un SU d'un important centre hospitalier universitaire. Sur une pé riode de 6 mois, tous les patients chez qui un diagnostic clinique de colique né phré tique avait é té posé et pour lesquels la sortie é tait pré vue ont passé une TDM sans densification à faible dose au SU. Les femmes enceintes, celles en â ge de procré er qui ne souhaitaient pas passer un test de grossesse et les patients qui avaient dé jà subi de...

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Diagnostic Performance of Low-Dose CT for the Detection of Urolithiasis: A Meta-Analysis

Abstract: The results of this meta-analysis suggest that a low-dose CT protocol can be used as the initial imaging technique in the workup of patients with suspected urolithiasis.

Cited by 257 publications

References 49 publications

Flouroscopy-free technique is safe and feasible in retrograde intrarenal surgery for renal stones

Flouroscopy-free technique is safe and feasible in retrograde intrarenal surgery for renal stones

Low Dose MDCT with Tube Current Modulation: Role in Detection of Urolithiasis and Patient Effective Dose Reduction

Prevalence of alternative diagnoses in patients with suspected uncomplicated renal colic undergoing computed tomography: a prospective study

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