Comparison of diagnostic accuracy of ultra low-dose computed tomography and X-ray of the kidneys, ureters and bladder for urolithiasis in the follow-up setting.
J Med Imaging Radiat Oncol
; 68(2): 132-140, 2024 Mar.
Article
en En
| MEDLINE
| ID: mdl-37997533
ABSTRACT
INTRODUCTION:
Urolithiasis is frequently followed up with a low-dose computed tomography of the kidneys ureters and bladder (LD-CTKUB) with doses typically less than 3 millisieverts. Although X-ray is a lower dose (0.5-1.1 mSv) alternative for follow up, it has lower diagnostic accuracy and is limited to radiopaque calculi. This study aims to compare the diagnostic accuracy of sub-millisievert ultra-low dose CT (ULD-CTKUB) against X-ray KUB for the follow up of urolithiasis when both are compared against the standard of care of a low-dose CT KUB (LD-CTKUB).METHODS:
This prospective study included patients with a known diagnosis of urolithiasis on prior CTKUB presenting for follow up. Each patient underwent a repeat reference LD-CTKUB, ULD-CTKUB and X-ray KUB. All imaging studies were interpreted by three readers. The radiation dose and quantitative noise was calculated for each CT. Both CT and X-ray were assessed for the presence, number and size of all calculi ≥2 mm.RESULTS:
A total of 58 patients were included in this study. LD-CTKUB identified 197 calculi. ULD-CTKUB in our study had a mean effective dose of 0.5 mSv compared to X-ray KUB where doses range in the literature from 0.5 to 1.1 mSv. Per-patient pooled analysis for intrarenal calculi when comparing ULD-CTKUB versus X-ray KUB against a reference LD-CTKUB found a sensitivity of 90% versus 67% (P < 0.01) and specificity of 93% versus 98% (P = 0.18) respectively. For ureteric calculi, the sensitivity was 67% versus 33% (P < 0.01) and specificity 94% versus 94% (P = 1.00) respectively. Per-stone pooled analysis detection rate was 79% for ULD-CTKUB versus 48% for X-ray (P < 0.01) when each was compared to the reference LD-CTKUB. Interobserver agreement was high for intrarenal calculi and moderate for ureteric calculi.CONCLUSION:
Sub-millisievert ULD-CTKUB had lower doses and higher sensitivity than X-ray in patients requiring follow up of known urolithiasis.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Uréter
/
Cálculos Ureterales
/
Cálculos Urinarios
/
Urolitiasis
Límite:
Humans
Idioma:
En
Revista:
J Med Imaging Radiat Oncol
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
NEOPLASIAS
/
RADIOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Australia