Ultrasonography Significantly Overestimates Stone Size When Compared to Low-dose, Noncontrast Computed Tomography

Sternberg, Kevan; Eisner, Brian H.; Larson, Troy; Hernández, Natalia; Han, Jaewon; Pais, Vernon M.

doi:10.1016/j.urology.2016.06.002

Cited by 36 publications

(24 citation statements)

References 19 publications

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“…It is already known that intraoperative visual stone assessment and measurements using regular preoperative diagnostic tools (i.e., CT and ultrasound) are biased [ 12 – 14 ]. Other experimental methods such as ultrasound strain sonography have not yet gained clinical application [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

A New Automatically Fixating Stone Basket (2.5 F) Prototype with a Nitinol Spring for Accurate Ureteroscopic Stone Size Measurement

Cordes

Nguyen²,

Pinkowski³

et al. 2018

Adv Ther

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IntroductionIntraoperative assessment of stone size is crucial for the successful and safe extraction of stones. The first automatically fixating measuring stone basket prototype showed a mismatch between the steel spring and the nitinol basket; therefore, to improve this prototype, the steel spring was replaced with a nitinol spring and a modified scale was implemented on the basket handle for accurate intraoperative stone size measurement.MethodsThe proposed tipped basket was composed of nitinol. A standard handle with a spring-supported self-closing mechanism (2.5 F, Urotech®) was used, and a modified nonlinear millimeter scale was established on the handle. The grasping force was provided by the new nitinol spring mechanism in the handgrip. Various colors associated with the stone size were applied on the scale.ResultsThe material difference between the basket and the spring was eliminated. The measuring scale ranged from 2 mm (green) through 5 mm (yellow) to 8 mm (red), and the scale was nonlinear because of the nonlinear relationship between the diameter of the stone and the distance marked on the scale.ConclusionThe proposed automatically fixating stone basket with a nitinol spring has the potential to improve the safety and effectiveness of endourological stone retrieval. Further validation of this new scale and basket should follow.

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Section: Discussionmentioning

confidence: 99%

A New Automatically Fixating Stone Basket (2.5 F) Prototype with a Nitinol Spring for Accurate Ureteroscopic Stone Size Measurement

Cordes

Nguyen²,

Pinkowski³

et al. 2018

Adv Ther

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show abstract

“…It is reasonable that the ability to more sharply define the borders of the stone will reduce stone sizing error. Considering the typical stone-sizing error with B-mode of 2-3mm compared to non-contrast CT,[ 9 , 11 , 12 ] even small improvements in ultrasound performance may have significant clinical impact. Notably, often the decision to observe or perform surgical intervention is on the order of millimeters.…”

Section: Discussionmentioning

confidence: 99%

“…[ 2 ] Among pediatric populations and pregnant women with kidney stones, several guideline panels recommend ultrasound as the first-line imaging modality for stone disease. [ 3 – 5 ] Despite the advantages with ultrasound, it suffers from poorer sensitivity (24–69%), diminished specificity (82–91%), and overestimation of stone size of approximately 2-3mm compared to CT. [ 6 – 12 ] It is not surprising that the role of ultrasound is currently limited to screening in the acute setting and surveillance. [ 2 – 4 , 13 – 15 ] Improving the detection and sizing tasks would provide kidney stone patients more of the benefits inherent to ultrasound imaging.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of non-linear beamforming ultrasound methods to characterize and size kidney stones

et al. 2018

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PurposeUltrasound methods for kidney stone imaging suffer from poor sensitivity and size overestimation. The study objective was to demonstrate feasibility of non-linear ultrasound beamforming methods for stone imaging, including plane wave synthetic focusing (PWSF), short-lag spatial coherence (SLSC) imaging, mid-lag spatial coherence (MLSC) imaging with incoherent compounding, and aperture domain model image reconstruction (ADMIRE).Materials and methodsThe ultrasound techniques were evaluated in an in vitro kidney stone model and in a pilot study of 5 human stone formers (n = 6 stones). Stone contrast, contrast-to-noise ratio (CNR), sizing, posterior shadow contrast, and shadow width sizing were compared among the different techniques and to B-mode. CT imaging within 60 days was considered the gold standard stone size. Paired t-tests using Bonferroni correction were performed to evaluate comparing each technique with B-mode.ResultsMean CT measured stone size was 6.0mm (range 2.9–12.2mm) with mean skin-to-stone distance 10.2cm (range 5.4–16.3cm). Compared to B-mode, stone contrast was best with ADMIRE (mean +12.2dB), while SLSC and MLSC showed statistically improved CNR. Sizing was best with ADMIRE (mean +1.3mm error), however this was not significantly improved over B-mode (+2.4mm). PWSF performed similarly to B-mode for stone contrast, CNR, SNR, and stone sizing. In the in vitro model, the shadow contrast was highest with ADMIRE (mean 10.5 dB vs 3.1 dB with B-mode). Shadow sizing was best with SLSC (mean error +0.9mm ± 2.9), however the difference compared to B-mode was not significant.ConclusionsThe detection and sizing of stones are feasible with advanced beamforming methods with ultrasound. ADMIRE, SLSC, and MLSC hold promise for improving stone detection, shadow contrast, and sizing.

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“…Similarly, Sternberg et al. showed that the largest stone diameter was over‐estimated by an average of 2.2 mm with US, and that errors increased with reducing stone size, rising from a 3% difference in stones >10 mm to 27% for those of 5–10 mm, and an 85% difference in stones ≤5 mm.…”

mentioning

confidence: 94%

Ultrasonography vs computed tomography for stone size

Smith

Patel

2017

BJU International

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Ultrasonography Significantly Overestimates Stone Size When Compared to Low-dose, Noncontrast Computed Tomography

Cited by 36 publications

References 19 publications

A New Automatically Fixating Stone Basket (2.5 F) Prototype with a Nitinol Spring for Accurate Ureteroscopic Stone Size Measurement

A New Automatically Fixating Stone Basket (2.5 F) Prototype with a Nitinol Spring for Accurate Ureteroscopic Stone Size Measurement

Feasibility of non-linear beamforming ultrasound methods to characterize and size kidney stones

Ultrasonography vs computed tomography for stone size

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