Variation in Radiologic and Urologic Computed Tomography Interpretation of Urinary Tract Stone Burden

Results From the Registry for Stones of the Kidney and Ureter

David T. Tzou, Dylan Isaacson, Manint Usawachintachit, Zhen J. Wang, Kazumi Taguchi, Nancy K. Hills, Ryan S. Hsi, Benjamin A. Sherer, Shalonda Reliford-Titus, Brian Duty, Jonathan D. Harper, Mathew Sorensen, Roger L. Sur, Marshall L. Stoller, Thomas Chi

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish (US)
JournalUrology
DOIs
StateAccepted/In press - Jan 1 2017

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Urinary Calculi
Kidney Calculi
Ureter
Registries
Tomography
Guidelines
Kidney
Urologists
Radiologists
Therapeutics

ASJC Scopus subject areas

  • Urology

Cite this

Variation in Radiologic and Urologic Computed Tomography Interpretation of Urinary Tract Stone Burden : Results From the Registry for Stones of the Kidney and Ureter. / Tzou, David T.; Isaacson, Dylan; Usawachintachit, Manint; Wang, Zhen J.; Taguchi, Kazumi; Hills, Nancy K.; Hsi, Ryan S.; Sherer, Benjamin A.; Reliford-Titus, Shalonda; Duty, Brian; Harper, Jonathan D.; Sorensen, Mathew; Sur, Roger L.; Stoller, Marshall L.; Chi, Thomas.

In: Urology, 01.01.2017.

Research output: Contribution to journalArticle

Tzou, DT, Isaacson, D, Usawachintachit, M, Wang, ZJ, Taguchi, K, Hills, NK, Hsi, RS, Sherer, BA, Reliford-Titus, S, Duty, B, Harper, JD, Sorensen, M, Sur, RL, Stoller, ML & Chi, T 2017, 'Variation in Radiologic and Urologic Computed Tomography Interpretation of Urinary Tract Stone Burden: Results From the Registry for Stones of the Kidney and Ureter', Urology. https://doi.org/10.1016/j.urology.2017.10.002
Tzou, David T. ; Isaacson, Dylan ; Usawachintachit, Manint ; Wang, Zhen J. ; Taguchi, Kazumi ; Hills, Nancy K. ; Hsi, Ryan S. ; Sherer, Benjamin A. ; Reliford-Titus, Shalonda ; Duty, Brian ; Harper, Jonathan D. ; Sorensen, Mathew ; Sur, Roger L. ; Stoller, Marshall L. ; Chi, Thomas. / Variation in Radiologic and Urologic Computed Tomography Interpretation of Urinary Tract Stone Burden : Results From the Registry for Stones of the Kidney and Ureter. In: Urology. 2017.
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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.",
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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

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Y1 - 2017/1/1

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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