MP05-05 DIGITAL TOMOSYNTHESIS: A VIABLE ALTERNATIVE TO NON-CONTRASTED COMPUTED TOMOGRAPHY FOR THE FOLLOW UP OF NEPHROLITHIASIS? (2016)

You have accessJournal of UrologyImaging/Radiology: Uroradiology I1 Apr 2016MP05-05 DIGITAL TOMOSYNTHESIS: A VIABLE ALTERNATIVE TO NON-CONTRASTED COMPUTED TOMOGRAPHY FOR THE FOLLOW UP OF NEPHROLITHIASIS? Adam Kaplan, Fernando Cabrera, Ramy Youssef, Matvey Tsivian, Richard Shin, Charles Scales, Glenn Preminger, and Michael Lipkin Adam KaplanAdam Kaplan More articles by this author , Fernando CabreraFernando Cabrera More articles by this author , Ramy YoussefRamy Youssef More articles by this author , Matvey TsivianMatvey Tsivian More articles by this author , Richard ShinRichard Shin More articles by this author , Charles ScalesCharles Scales More articles by this author , Glenn PremingerGlenn Preminger More articles by this author , and Michael LipkinMichael Lipkin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1982AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Digital tomosynthesis (DT) is a new X-ray based, imaging technique that allows image enhancement with minimal increase in radiation exposure. The purpose of this study was to compare DT with non-contrasted computed tomography (NCCT) and to evaluate its potential role for the follow up of patients with nephrolithiasis in a non-emergent setting. METHODS A retrospective review of patients with nephrolithiasis at our institution that underwent NCCT and DT from July 2012 to September 2013 was performed. Renal units that did not undergo treatment or stone passage were randomly assigned to two blinded readers, who recorded stone count, size area (mm2), maximum stone length (mm) and location, for both DT and NCCT. Mean differences per renal unit were compared. Stone size was further classified for the largest stone per renal unit detected by NCCT into the following categories: <5mm, 5-10mm and >10mm. Potential variables affecting stone detection rate including, stone size and BMI were evaluated. Inter-observer agreement was determined using the intra-class correlation coefficient (ICC). RESULTS Of the 79 renal units assessed, 41 exhibited exact stone counts on DT and NCCT. At total of 352 and 337 stones were detected on DT and NCCT, respectively, of which more than 50% were ≤3mm in size. Mean stone count per renal unit was 4.46 and 4.27 for DT and NCCT respectively. The mean difference in stone area was 16.5mm2 (-4.6-38.5), p=0.121. Stratification by stone size showed minimal difference in stone count and size, especially for smaller stones <5mm. Correlation between BMI and stone detection rates was 0.06 and 0.05 for stone count and stone area (mm2), respectively. ICC for stone size was 0.89 and 0.86 for DT and NCCT, indicating strong correlation between readers and adequate reproducibility. CONCLUSIONS We found DT to be a comparable imaging modality to NCCT for the detection of intra-renal stones, without a significant effect from stone size and BMI and adequate reproducibility between multiple readers. DT appears to be an ideal alternative for following patients with nephrolithiasis due to its acceptable stone detection rates, low radiation exposure and decreased cost as compared to NCCT. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e38-e39 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Adam Kaplan More articles by this author Fernando Cabrera More articles by this author Ramy Youssef More articles by this author Matvey Tsivian More articles by this author Richard Shin More articles by this author Charles Scales More articles by this author Glenn Preminger More articles by this author Michael Lipkin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...