TY - JOUR
T1 - Variation in Radiologic and Urologic Computed Tomography Interpretation of Urinary Tract Stone Burden
T2 - Results From the Registry for Stones of the Kidney and Ureter
AU - Tzou, David T.
AU - Isaacson, Dylan
AU - Usawachintachit, Manint
AU - Wang, Zhen J.
AU - Taguchi, Kazumi
AU - Hills, Nancy K.
AU - Hsi, Ryan S.
AU - Sherer, Benjamin A.
AU - Reliford-Titus, Shalonda
AU - Duty, Brian
AU - Harper, Jonathan D.
AU - Sorensen, Mathew
AU - Sur, Roger L.
AU - Stoller, Marshall L.
AU - Chi, Thomas
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/1
Y1 - 2018/1
N2 - 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.
AB - 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.
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U2 - 10.1016/j.urology.2017.10.002
DO - 10.1016/j.urology.2017.10.002
M3 - Article
C2 - 29032235
AN - SCOPUS:85034956094
SN - 0090-4295
VL - 111
SP - 59
EP - 64
JO - Urology
JF - Urology
ER -