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Urology. 2018 Jan;111:59-64. doi: 10.1016/j.urology.2017.10.002. Epub 2017 Oct 13.

Variation in Radiologic and Urologic Computed Tomography Interpretation of Urinary Tract Stone Burden: Results From the Registry for Stones of the Kidney and Ureter.

Author information

1
Department of Urology, University of California San Francisco, San Francisco, CA.
2
Department of Urology, University of California San Francisco, San Francisco, CA; Division of Urology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
3
Department of Radiology, University of California San Francisco, San Francisco, CA.
4
Department of Urology, University of California San Francisco, San Francisco, CA; Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
5
Department of Neurology, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA.
6
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.
7
Department of Urology, Oregon Health & Science University, Portland, OR.
8
Department of Urology, University of Washington, Seattle, WA.
9
Department of Urology, University of California San Diego, San Diego, CA.
10
Department of Urology, University of California San Francisco, San Francisco, CA. Electronic address: Tom.Chi@ucsf.edu.

Abstract

OBJECTIVE:

To compare the measured stone burden recorded between urologists and radiologists, and examine how these differences could potentially impact stone management. As current urologic stone surgery guideline recommendations are based on stone size, accurate stone measurements are crucial to direct appropriate treatment. This study investigated the discrepant interpretation that often exists between urologic surgeons and radiologists' estimation of patient urinary stone burden.

MATERIALS AND METHODS:

From November 2015 through August 2016, new patients prospectively enrolled into the Registry for Stones of the Kidney and Ureter (ReSKU) were included if they had computed tomography images available and an accompanying official radiologic report at the time of their urologist provider visit. Stone number and aggregate stone size were compared between the urologic interpretation and the corresponding radiologic reports.

RESULTS:

Of 219 patients who met the inclusion criteria, concordance between urologic and radiologic assessment of aggregate stone size was higher for single stone sizing (63%) compared with multiple stones (32%). Statistical significance was found in comparing the mean difference in aggregate stone size for single and multiple stones (P <.01). Over 33% of stone-containing renal units had a radiologic report with an unclear size estimation or size discrepancy that could lead to non-guideline-driven surgical management.

CONCLUSION:

Significant variation exists between urologic and radiologic computed tomography interpretations of stone burden. Urologists should personally review patient imaging when considering stone surgical management. A standardized method for measuring and reporting stone parameters is needed among urologists and radiologists.

PMID:
29032235
PMCID:
PMC6139031
DOI:
10.1016/j.urology.2017.10.002
[Indexed for MEDLINE]
Free PMC Article

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