Detectability of urinary tract calculi by Computed Radiography (CR) in patients with renal colic

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Detectability of urinary tract calculi by Computed Radiography (CR) in patients with renal colic

 

Author: Kwok, Wing-hei
Title: Detectability of urinary tract calculi by Computed Radiography (CR) in patients with renal colic
Degree: M.Sc.
Year: 2002
Subject: Hong Kong Polytechnic University -- Dissertations
Urinary organs -- Radiography
Radiography, Medical -- Data processing
Department: Multi-disciplinary Studies
Dept. of Optometry and Radiography
Pages: iv, 79 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1641694
URI: http://theses.lib.polyu.edu.hk/handle/200/5309
Abstract: Objectives. The aim of this study was to evaluate the performance of Computed Radiography (CR) in detecting urinary tract calculi, in order to determine whether CR may replace some Computed Tomography (CT) examinations for suspected or proven urinary tract calculi, with consequent savings in patient dose, cost and time. The specific objectives were to determine the sensitivity, specificity and accuracy of CR in detecting urinary tract calculi, as well as to compare CR and CT in detecting urinary tract calculi. Materials and Methods. The archives at North District Hospital from 1998 to 2001 were reviewed retrospectively for patients presenting with renal colic, who had undergone both non-contrast helical CT and abdominal CR. One hundred and thirty-nine cases were selected. Two radiologists reviewed the films independently, and CT and CR images were reviewed separately to prevent bias. When discrepancy of diagnosis occurred for the same image, the radiologists would discuss to achieve consensus. If discrepancy occurred between CR and CT images, the radiologists would review the CR image again, together with the CT films. The results for the blinded and unblinded CR reporting were recorded separately. Sensitivity, specificity and accuracy of CR were determined, by using CT as the gold standard. Results. A total of 130 cases were found, resulting in 187 subjects. For blinded CR reporting (i.e. without knowing the CT diagnosis), the sensitivity, specificity and accuracy were 52%, 69% and 56% respectively (+-7%, 95% C.I.). For unblended CR reporting (knowing the CT diagnosis), the sensitivity, specificity and accuracy improved to 59%, 100% and 68% respectively (+-7%, 95% C.I.). There was statistically significant difference in the sensitivity of CR and CT in detecting all urinary tract calculi (p=0.0005). When only calculi >= 4 mm were counted, the sensitivity, specificity and accuracy for blinded CR reporting became 72%, 69% and 71% respectively (+-8%, 95% C.I.). Whereas the sensitivity, specificity and accuracy for unblinded CR reporting became 83%, 100% and 88% respectively (+-6%, 95% C.I.). Conclusion. When compared with non-contrast abdominal CT examination, using CR abdominal plain radiography is convenient, faster, less expensive and gives lower radiation dose to the patient. CR has high sensitivity, specificity and accuracy in detecting urinary tract calculi >= 4 mm. Adopting the practice of using CR as follow-up imaging will significantly reduce the radiation dose to the patient, the use of resources, cost and time. It is also reasonable and acceptable to use CR in detecting urinary tract calculi for initial patient management decisions, when CT service is not available.

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