Ultrasound Versus Computerized Tomography for Evaluating Urolithiasis

Passerotti, Carlo C.; Chow, Jeanne S.; Silva, Andres; Schoettler, Cynthia; Rosoklija, Ilina; Peréz-Rosselló, Jeannette M.; Cendron, Marc; Cilento, Bartley G.; Lee, Richard S.; Nelson, Caleb P.; Estrada, Carlos R.; Bauer, Stuart B.; Borer, Joseph G.; Diamond, David A.; Retik, Alan B.; Nguyen, Hiep T.

doi:10.1016/j.juro.2009.03.072

Cited by 108 publications

(69 citation statements)

References 21 publications

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“…In our study, the diagnostic accuracy of US was similar to that reported in the literature [3,12]. However, US fault to show small-sized renal stones.…”

Section: Discussionsupporting

confidence: 91%

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Comparison of Ultrasonography and Low-Dose Computed Tomography for the Diagnosis of Pediatric Urolithiasis in the Emergency Department

et al. 2017

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Objective: This study aimed to compare ultrasonography (US) and low-dose computed tomography (LDCT) for diagnosing pediatric urolithiasis in the emergency department. Materials and Methods: This retrospective study was approved by our institutional ethics committee, and informed consent was waived. From March 2016 to March 2017, 100 consecutive patients met the selection criteria and were enrolled in the study. Patients were randomly selected in a 1:1 ratio and were allocated to one of the following two imaging groups: US or abdominal LDCT. LDCT examinations were performed using a 320-detector row CT. Radiation dose analysis was performed using Radimetrics. US examinations were performed using the Aplio 500 ultrasound system. The presence of urolithiasis, anatomical location of urolithiasis, and measurements of renal stones were evaluated and recorded. Results: There were statistically significant differences between US and standard-dose CT (SDCT) with respect to the diagnosis of urolithiasis, anatomical location of urolithiasis, and measurements of renal stones (p<0.001, p=0.005, and p=0.03, respectively). The mean effective radiation dose of LDCT was 1.44±0.34 mSv and that of SDCT was calculated to be 4.36±1.33 mSv. There was no statistically significant difference between LDCT and SDCT with regard to the diagnosis of urolithiasis, anatomical location of urolithiasis and measurements of renal stones (p=1 for all). The diagnostic accuracy of US and LDCT was 0.68 and 1.0, respectively. Conclusion: Low-dose computed tomography had 1/3 SDCT radiation dose, and LDCT and SDCT accurately diagnosed pediatric urolithiasis in the emergency department. US had a lower accuracy than SDCT and LDCT for diagnosing pediatric urolithiasis in the emergency department. LDCT can be an alternative for SDCT for diagnosing pediatric urolithiasis. Keywords: Urolithiasis, emergency, ultrasonography, computed tomography, pediatric, radimetrics ÖZ Amaç: Bu çalışmamızda acil serviste çocuk hastalarda üriner sistem taş tanısında ultrason (US) ve düşük doz bilgisayarlı tomografinin (DDBT) karşılaştırılması. Gereç ve Yöntemler: 2016 Mart ve 2017 Mart tarihleri arasında toplam 100 hasta çalışmaya dahil edildi. Hastalar 1e 1e oranında US ve DDBT grubuna seçildi. BT incelemeleri 320 kesitli BT cihazı ile gerçekleştirildir. Radyasyon dozları Radimetrics programı kullanılarak hesaplandı. US incelemeleri Aplio 500 cihazında gerçek-leştirildi. Taş varlığı, taş lokalizasyonu ve taş boyutları ölçüldü. Bulgular: Taş varlığı, taş lokalizasyonu ve taş boyutlarında US ve standard dose BT (SBT) arasında istatistiksel fark vardı (p<0,001, p=0,005 ve p=0,03, sırasıyla). US'nin tanısal başarısı 0,68 ve DDBT'nin tanısal başarısı 1 bulundu. DDBT de ortalama efektif radyasyon doz 1,44±0,34 mSv bulundu. SBT' de ortalama efektif radyasyon doz 4,36±1,33mSv bulundu. Taş varlığı, taş lokalizasyonu ve taş boyutlarında DDBT ve SBT arasında istatistiksel fark yoktu (p=1). Sonuç: Düşük doz bilgisayarlı tomografinin dozu SBT'nin 1/3ü kadardır, DDBT acil serviste ...

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“…In our study, the diagnostic accuracy of US was similar to that reported in the literature [3,12]. However, US fault to show small-sized renal stones.…”

Section: Discussionsupporting

confidence: 91%

“…US is the first preferred imaging modality. In addition, LDCT is an important method that could be used when US is not sufficient.In our study, the diagnostic accuracy of US was similar to that reported in the literature [3,12]. However, US fault to show small-sized renal stones.…”

supporting

confidence: 91%

Comparison of Ultrasonography and Low-Dose Computed Tomography for the Diagnosis of Pediatric Urolithiasis in the Emergency Department

et al. 2017

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“…The rationale for using ultrasound as the initial screening modality for children with suspected nephrolithiasis is that ultrasound accurately localizes most clinically important stones in children 17,18 and CT can be reserved for children with a nondiagnostic ultrasound for whom the clinical suspicion for stones remains high. Passerotti et al 18 observed that the sensitivity and specificity of ultrasound for 50 children with suspected nephrolithiasis were 70% and 100%, respectively, when compared with CT. Of the stones not visualized on ultrasound, 25% were in the ureter and the remainder were nonobstructive stones in the kidney.…”

Section: Discussionmentioning

confidence: 99%

Use of and Regional Variation in Initial CT Imaging for Kidney Stones

et al. 2014

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OBJECTIVE: We sought to determine the prevalence of initial computed tomography (CT) utilization and to identify regions in the United States where CT is highly used as the first imaging study for children with nephrolithiasis. METHODS: We performed a cross-sectional study in 9228 commercially insured children aged 1 to 17 years with nephrolithiasis who underwent diagnostic imaging in the United States between 2003 and 2011. Data were obtained from MarketScan, a commercial insurance claims database of 17 827 229 children in all 50 states. We determined the prevalence of initial CT use, defined as CT alone or CT performed before ultrasound in the emergency department, inpatient unit, or outpatient clinic, and identified regions of high CT utilization by using logistic regression. RESULTS: Sixty-three percent of children underwent initial CT study and 24% had ultrasound performed first. By state, the proportion of children who underwent initial CT ranged from 41% to 79%. Regional variations persisted after adjusting for age, gender, year of presentation, and insurance type. Relative to children living in West South Central states, the highest odds of initial CT utilization were observed for children living in the East South Central US Census division (odds ratio: 1.27; 95% confidence interval: 1.06–1.54). The lowest odds of initial CT were observed for children in the New England states (odds ratio: 0.48; 95% confidence interval: 0.38–0.62). CONCLUSIONS: Use of CT as the initial imaging study for children with nephrolithiasis is highly prevalent and shows extensive regional variability in the United States. Current imaging practices deviate substantially from recently published guidelines that recommend ultrasound as the initial imaging study.

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“…The majority of pediatric patients will present with stones in an idiopathic manner, but 924% will have an associated secondary cause such as congenital urinary tract anomaly, metabolic deficiency, or neurologic disease [Alpay et al 2009;Kalorin et al 2009;Dursun et al 2008;Kit et al 2008;VanDervoort et al 2007;Sternberg et al 2005;Alon et al 2004]. Overall, approximately 5060% of patients have stones located in the kidney at the time of diagnosis [Passerotti et al 2009;Palmer et al 2005;Sternberg et al 2005;Kroovand, 1997]. With increasing age, though, this ratio is reversed, and in older children, the majority of stones can be found within the ureter [Kalorin et al 2009;Pietrow et al 2002].…”

Section: Pediatric Urolithiasismentioning

confidence: 99%

The increasing pediatric stone disease problem

Clayton

Pope

2011

Therapeutic Advances in Urology

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While once thought to be relatively rare in developed nations, the prevalence of pediatric urolithiasis appears to be increasing, and a number of factors may be contributing to this increase. Many theories are plausible and such theories include the increasing childhood obesity epidemic, a changing sex predilection, climate change, alterations in dietary habits and improving diagnostic modalities. Yet, unlike adult patients, rigorous epidemiologic studies do not exist in pediatric populations. Thus, in the setting of an increasing prevalence of childhood stone disease, improved research is critical to the development of uniform strategies for pediatric urolithiasis management.

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Ultrasound Versus Computerized Tomography for Evaluating Urolithiasis

Cited by 108 publications

References 21 publications

Comparison of Ultrasonography and Low-Dose Computed Tomography for the Diagnosis of Pediatric Urolithiasis in the Emergency Department

Comparison of Ultrasonography and Low-Dose Computed Tomography for the Diagnosis of Pediatric Urolithiasis in the Emergency Department

Use of and Regional Variation in Initial CT Imaging for Kidney Stones

The increasing pediatric stone disease problem

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