To investigate the diagnostic value of digital tomosynthesis in urolithiasis compared with multidetector computed tomography (MDCT).
Subjects and Methods:
This study received the approval of institutional review board and obtained the informed consents of all subjects. Fifty patients with acute renal colic and hematuria from February 2014 to February 2015 were enrolled. They underwent both MDCT and digital tomosynthesis. Images were interpreted by two experienced radiologists, and inter-reader agreement was assessed. The diagnostic performance of urinary stones with digital tomosynthesis and MDCT was compared. The entrance surface dose (ESD) in MDCT and digital tomosynthesis for patients was measured and compared.
Results:
No significant difference was found between digital tomosynthesis and MDCT in the diagnosis of urinary stones (X2 = 1.357, p > 0.05). The ESD in digital tomosynthesis was lower than that in both routine-dose and low-dose MDCT for patients (p < 0.05).
Conclusions:
Digital tomosynthesis has great diagnostic value in urolithiasis. Compared with MDCT, digital tomosynthesis can significantly decrease ESD for patients and financial loan with a similar detection rate.
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References
1.
TurneyBW, ReynardJM, NobleJG, KeoghaneSR. Trends in urological stone disease. BJU Int, 2012; 109:1082–1087.
2.
LevineJA, NeitlichJ, VergaM, DalrympleN, SmithRC. Ureteral calculi in patients with flank pain: Correlation of plain radiography with unenhanced helical CT. Radiology, 1997; 204:27–31.
3.
RothCS, BowyerBA, BerquistTH. Utility of the plain abdominal radiograph for diagnosing ureteral calculi. Ann Emerg Med, 1985; 14:311–315.
4.
MutgiA, WilliamsJW, NettlemanM. Renal colic. Utility of the plain abdominal roentgenogram. Arch Intern Med, 1991; 151:1589–1592.
5.
RosenCL, BrownDF, SagarinMJ, ChangY, McCabeCJ, WolfeRE. Ultrasonography by emergency physicians in patients with suspected ureteral colic. J Emerg Med, 1998; 16:865–870.
6.
HendersonSO, HoffnerRJ, AragonaJL, GrothDE, EsekogwuVI, ChanD. Bedside emergency department ultrasonography plus radiography of the kidneys, ureters, and bladder vs intravenous pyelography in the evaluation of suspected ureteral colic. Acad Emerg Med, 1998; 5:666–671.
7.
FowlerKA, LockenJA, DuchesneJH, WilliamsonMR. US for detecting renal calculi with nonenhanced CT as a reference standard. Radiology, 2002; 222:109–113.
8.
UlusanS, KocZ, TokmakN. Accuracy of sonography for detecting renal stone: Comparison with CT. J Clin Ultrasound, 2007; 35:256–261.
9.
SinclairD, WilsonS, ToiA, GreenspanL. The evaluation of suspected renal colic: Ultrasound scan versus excretory urography. Ann Emerg Med, 1989; 18:556–559.
10.
PfisterSA, DeckartA, LaschkeS, et al.Unenhanced helical computed tomography vs intravenous urography in patients with acute flank pain: Accuracy and economic impact in a randomized prospective trial. Eur Radiol, 2003; 13:2513–2520.
11.
ShineS. Urinary calculus: IVU vs. CT renal stone? A critically appraised topic. Abdom Imaging, 2008; 33:41–43.
12.
ChuG, RosenfieldAT, AndersonK, ScoutL, SmithRC. Sensitivity and value of digital CT scout radiography for detecting ureteral stones in patients with ureterolithiasis diagnosed on unenhanced CT. AJR Am J Roentgenol, 1999; 173:417–423.
13.
RemerEM, HertsBR, StreemSB, HesselinkDP, ShieslyDA, YostAJ, BakerME. Spiral noncontrast CT versus combined plain radiography and renal US after extracorporeal shock wave lithotripsy: Cost-identification analysis. Radiology, 1997; 204:33–37.
14.
SheaforDH, HertzbergBS, FreedKS, CarrollBA, KeoganMT, PaulsonEK, DeLongDM, NelsonRC. Nonenhanced helical CT and US in the emergency evaluation of patients with renal colic: Prospective comparison. Radiology, 2000; 217:792–797.
15.
SmithRC, RosenfieldAT, ChoeKA, EssenmacherKR, VergaM, GlickmanMG, LangeRC. Acute flank pain: Comparison of non-contrast-enhanced CT and intravenous urography. Radiology, 1995; 194:789–794.
16.
ZagoriaRJ. Retrospective view of “diagnosis of acute flank pain: value of unenhanced helical CT.”. AJR Am J Roentgenol, 2006; 187:603–604.
17.
LumermanJ, GershbaumMD, HinesJ, NardiP, BeuchertP, KatzDS. Unenhanced helical computed tomography for the evaluation of suspected renal colic in the adolescent population: A pilot study. Urology, 2001; 57:342–346.
18.
TackD, SourtzisS, DelpierreI, de MaertelaerV, GevenoisPA. Low-dose unenhanced multidetector CT of patients with suspected renal colic. AJR Am J Roentgenol, 2003; 180:305–311.
19.
KlunerC, HeinPA, GrallaO, HeinE, HammB, RomanoV, RogallaP. Does ultra-low-dose CT with a radiation dose equivalent to that of KUB suffice to detect renal and ureteral calculi?. J Comput Assist Tomogr, 2006; 30:44–50.
20.
PolettiPA, PlatonA, RutschmannOT, SchmidlinFR, IselinCE, BeckerCD. Low-dose versus standard-dose CT protocol in patients with clinically suspected renal colic. AJR Am J Roentgenol, 2007; 188:927–933.
21.
LiuW, EslerSJ, KennyBJ, GohRH, RainbowAJ, StevensonGW. Low-dose nonenhanced helical CT of renal colic: Assessment of ureteric stone detection and measurement of effective dose equivalent. Radiology, 2000; 215:51–54.
22.
BadeaC, KolitsiZ, PallikarakisN. A 3D imaging system for dental imaging based on digital tomosynthesis and cone beam CT. Proceedings of Conference of the International Federation for Medical and Biological Engineering, 2001; 2:739–741.
23.
StielGM, StielLG, KlotzE, NienaberCA. Digital flashing tomosynthesis: A promising technique for angiocardiographic screening. IEEE Trans Med Imaging, 1993; 12:314–321.
24.
WarpRJ, GodfreyDJ, DobbinsJT, 3rd. Applications of matrix inverse tomosynthesis. Proc SPIE Med Imaging, 2000; 3977:376–383.
25.
DuryeaJ, DobbinsJT, 3rd, LynchJA. Digital tomosynthesis of hand joints for arthritis assessment. Med Phys, 2003; 30:325–333.
26.
SomeS, KasugaT, SakaiF, et al.Image processing in the digital tomosynthesis for pulmonary imaging. Eur Radiol, 1995; 5:96–101.
27.
NiklasonLT, ChristianBT, NiklasonLE, et al.Digital tomosynthesis in breast imaging. Radiology, 1997; 205:399–406.
28.
MermuysK, De GeeterF, BacherK, Van De MoorteleK, CoenegrachtsK, SteyaertL, CasselmanJW. Digital tomosynthesis in the detection of urolithiasis: Diagnostic performance and dosimetry compared with digital radiography with MDCT as the reference standard. AJR Am J Roentgenol, 2010; 195:161–167.
29.
Purchasing CFE-B. Evaluation Report: Tomosynthesis for General Radiography. London, UK: NHS Purchasing and Supply Agency, 2009.
