Low Dose MDCT with Tube Current Modulation: Role in Detection of Urolithiasis and Patient Effective Dose Reduction

Koteshwar, Prakashini; Kakkar, Chandan; Sripathi, Smiti; Parakh, Anushri; Shrivastav, Rajendra

doi:10.7860/jcdr/2016/16765.7735

Cited by 4 publications

(7 citation statements)

References 22 publications

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“…The speci c value of the stone threshold remains uncertian. Phlebolith may cause the false-positive and false-negative ndings, especially in distal ureter and VUJ [20,28]. What is more, heterogeneity of renal stroma may also make it di cult to differentiate between hyperdense pyramids and small calculus, thus causing false-positive ndings [19].…”

Section: Discussionmentioning

confidence: 99%

“…What is more, heterogeneity of renal stroma may also make it di cult to differentiate between hyperdense pyramids and small calculus, thus causing false-positive ndings [19]. In additionm, passed off calculus should be taken into consideration as no calculus was detected on CT with haematuria and positive urine analysis [28].…”

Section: Discussionmentioning

confidence: 99%

“…full-text articles were later excluded due to these reasons: retrospective studies (n = 4), without speci c number of TP, FP, FN, TN(n = 3), without effective dose (n = 1). Finally, A total of 17 unique articles with 1,761 patients (mean age: 46.40) and 2,053 stones were included [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] for the quantitative analysis. 13 studies [14][15][16][17][18][19][20][21][22][23][24][25][26] were included in the former studies [10][11], and 4 studies [27][28][29][30] were new studies.…”

Section: Literature Search and Study Selectionmentioning

confidence: 99%

“…What is more, 12 studies [15-21, 23, 25, 29-30]were at unclear risk of bias of concerning the results of LDCT examination because that the use of threshold was unclear. 4 studies [16,17,20,28] were at unclear risk of bias in the ow and timing for the reasons that the information about the duration interval was unclear. There was unclear applicability concerns of patient selection because inappropriate exclusions were avoided in one study [22].…”

Section: Quality Assessmentmentioning

confidence: 99%

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The Diagnostic Accuracy of Low-Dose Computed Tomography in Diagnosing Urolithiasis: A Systematic Review and Meta-Analysis

Liang

Chang

Wang

et al. 2020

Preprint

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Background: Urolithiasis is a prevalent health issue all over the world,To evaluate the diagnostic accuracy of low-lose computed tomography(LDCT) for detecting urolithiasis. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. PubMed, EMBASE and The Cochrane Library were searched for original diagnostic studies to identify all relevant studies published prior to May 2020. The index test was LDCT, and the reference standards were comprehensive diagnosis or standard-dose CT (SDCT). Results: 17 studies with 1,761 patients and 2,053 stones were included for the quantitative analysis. The pooled sensitivity was 0.95 (95%CI: 0.93-0.97) in patient-based studies and 0.86 (95%CI: 0.76-0.93) in urolithiasis-based studies. The pooled specificity of LDCT were 0.97 (95%CI: 0.95-0.99) in patient-based studies and 0.98 (95%CI: 0.63-1.00) in urolithiasis-based studies. The Fagan nomogram of LDCT for diagnosis of urolithiasis showed that the probability of urolithiasis is 98% if the LDCT scan is positive and 6% if the LDCT scan is negative. The likelihood ratio plot showed that the summary positive pooled likelihood ratio (LRP) and negative likelihood ratio (LRN) for LDCT was in the left upper quadrant(LUQ) area. Conclusions: LDCT has excellent diagnostic value in urolithiasis. LDCT can detect the urolithiasis specifically, but is limited to differentiate the contents of the stones.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Literature Search and Study Selectionmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

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The Diagnostic Accuracy of Low-Dose Computed Tomography in Diagnosing Urolithiasis: A Systematic Review and Meta-Analysis

Liang

Chang

Wang

et al. 2020

Preprint

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“…With a sensitivity of 95–96% and a specificity of 97–100%, an unenhanced computed tomography (CT) scan of the abdomen and pelvis is considered a state-of-the-art method to confirm or eliminate suspected urolithiasis in symptomatic patients 5–7. As diagnosis by CT has become more widespread, radiation dose in patients has become a major concern 8–10. Consequently, attention has recently been directed to using low-dose CT protocols in order to reduce the effective radiation dose administered to the patient 8.…”

Section: Introductionmentioning

confidence: 99%

<p>Low-dose computed tomography of urolithiasis in obese patients: a feasibility study to evaluate image reconstruction algorithms</p>

Chang

Slebocki

Khristenko

et al. 2019

DMSO

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Purpose: Retrospective evaluation and comparison of image quality generated by low-dose computed tomography (LDCT) from obese patients with urolithiasis using alternative reconstruction algorithms. Materials and methods: Twenty-five obese patients (body mass index [BMI]>25 kg/m 2 ) underwent LDCT scans for suspected urolithiasis. The scans were recompiled using filtered-back projection (FBP), statistical iterative reconstruction (iDose) and iterative model-based reconstruction (IMR). Dose-length product (DLP) and patient details were obtained from the CT dose report and clinical charts, respectively. Objective image noise was assessed by measuring the SD of Hounsfield units (HUs) in defined locations. Additionally, subjective image evaluation was independently performed by two radiologists using a 3-point Likert scale. The inter-reviewer agreement of image quality was calculated. Results: Ureteral concretions were observed in all CT scans, two of which revealed bilateral stones. The assessed patients’ mean BMI was 29.29±3.74 kg/m 2 , and the DLP of the CT scans was 100.04±10.00 mGy*cm. All scans were rated diagnostic with the iDose and iterative model-based reconstructions, whereas 41% of the scans performed with FBP reconstruction were nondiagnostic. With respect to image quality, IMR was superior to iDose and FBP, both in the objective ( P <0.001) and overall subjective ( P ≤0.008) evaluation of the respective data sets. The inter-reviewer agreement for overall image quality was “almost perfect” for IMR, “substantial” for iDose and “moderate” for FBP (κ values of 1.0, 0.6 and 0.46, respectively). Conclusion: Using iterative image reconstruction algorithms, LDCT of urolithiasis is feasible in overweight patients with a BMI between 25 and 35 kg/m 2 . Due to higher image quality, IMR is the preferred algorithm for scan reconstruction as it may help to avoid repeated examinations due to initial nondiagnostic scans.

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Abdominal Radiography With Digital Tomosynthesis: An Alternative to Computed Tomography for Identification of Urinary Calculi?

Wollin

Gupta

Young

et al. 2018

Urology

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Low Dose MDCT with Tube Current Modulation: Role in Detection of Urolithiasis and Patient Effective Dose Reduction

Cited by 4 publications

References 22 publications

The Diagnostic Accuracy of Low-Dose Computed Tomography in Diagnosing Urolithiasis: A Systematic Review and Meta-Analysis

The Diagnostic Accuracy of Low-Dose Computed Tomography in Diagnosing Urolithiasis: A Systematic Review and Meta-Analysis

<p>Low-dose computed tomography of urolithiasis in obese patients: a feasibility study to evaluate image reconstruction algorithms</p>

Abdominal Radiography With Digital Tomosynthesis: An Alternative to Computed Tomography for Identification of Urinary Calculi?

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