Renal stones on portal venous phase contrast-enhanced CT: Does intravenous contrast interfere with detection?

R. Joshua Dym, Dameon R. Duncan, Michael Spektor, Hillel W. Cohen, Meir H. Scheinfeld

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose: To determine the sensitivity of portal venous phase contrast-enhanced CT for the detection of renal stones. Methods: This retrospective study included 97 CT examinations of the abdomen without and with intravenous contrast, including 85 (87.6%) examinations with at least one renal stone on the "gold standard" noncontrast images, as scored by a single radiologist. Three other radiologists each independently reviewed only the contrast-enhanced images from all 97 examinations and recorded all renal stones. Reviewer sensitivity for stones was categorized by stone diameter. Reviewer sensitivity and specificity for stone disease were also calculated on a per-kidney basis. Results: The 97 cases included a total of 238 stones ≥1 mm, with a mean (±SD) of 1.2 ± 1.9 stones per kidney and a stone diameter of 3.5 ± 3.0 mm. Pooling data for the three reviewers, sensitivity for all stones was 81%; sensitivity for stones ≥2, ≥3, ≥4, and ≥5 mm was 88%, 95%, 99%, and 98%, respectively. Sensitivity for stone disease on a per-kidney basis was 94% when considering all stones; when considering only stones ≥2, ≥3, and ≥4 mm, sensitivity was 96%, 99%, and 100%, respectively. Specificity for stone disease on a per-kidney basis was 98% overall, 99% when considering only stones ≥2 mm, and 100% when considering only stones ≥3 mm. Conclusion: Contrast-enhanced CT is highly sensitive for the detection of renal stones ≥3 mm in diameter and less sensitive for smaller stones. In cases where the clinical diagnosis is uncertain and performance of a CT examination is being contemplated, intravenous contrast utilization would allow assessment for stone disease while also optimizing evaluation for other conditions.

Original languageEnglish (US)
Pages (from-to)526-532
Number of pages7
JournalAbdominal Imaging
Volume39
Issue number3
DOIs
StatePublished - 2014

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Kidney
Kidney Calculi
Abdomen
Meta-Analysis
Retrospective Studies
Sensitivity and Specificity
Radiologists

Keywords

  • Calculi
  • CT
  • Emergency imaging
  • Intravenous contrast
  • Iodinated contrast
  • Renal stones

ASJC Scopus subject areas

  • Gastroenterology
  • Urology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Renal stones on portal venous phase contrast-enhanced CT : Does intravenous contrast interfere with detection? / Dym, R. Joshua; Duncan, Dameon R.; Spektor, Michael; Cohen, Hillel W.; Scheinfeld, Meir H.

In: Abdominal Imaging, Vol. 39, No. 3, 2014, p. 526-532.

Research output: Contribution to journalArticle

Dym, R. Joshua ; Duncan, Dameon R. ; Spektor, Michael ; Cohen, Hillel W. ; Scheinfeld, Meir H. / Renal stones on portal venous phase contrast-enhanced CT : Does intravenous contrast interfere with detection?. In: Abdominal Imaging. 2014 ; Vol. 39, No. 3. pp. 526-532.
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title = "Renal stones on portal venous phase contrast-enhanced CT: Does intravenous contrast interfere with detection?",
abstract = "Purpose: To determine the sensitivity of portal venous phase contrast-enhanced CT for the detection of renal stones. Methods: This retrospective study included 97 CT examinations of the abdomen without and with intravenous contrast, including 85 (87.6{\%}) examinations with at least one renal stone on the {"}gold standard{"} noncontrast images, as scored by a single radiologist. Three other radiologists each independently reviewed only the contrast-enhanced images from all 97 examinations and recorded all renal stones. Reviewer sensitivity for stones was categorized by stone diameter. Reviewer sensitivity and specificity for stone disease were also calculated on a per-kidney basis. Results: The 97 cases included a total of 238 stones ≥1 mm, with a mean (±SD) of 1.2 ± 1.9 stones per kidney and a stone diameter of 3.5 ± 3.0 mm. Pooling data for the three reviewers, sensitivity for all stones was 81{\%}; sensitivity for stones ≥2, ≥3, ≥4, and ≥5 mm was 88{\%}, 95{\%}, 99{\%}, and 98{\%}, respectively. Sensitivity for stone disease on a per-kidney basis was 94{\%} when considering all stones; when considering only stones ≥2, ≥3, and ≥4 mm, sensitivity was 96{\%}, 99{\%}, and 100{\%}, respectively. Specificity for stone disease on a per-kidney basis was 98{\%} overall, 99{\%} when considering only stones ≥2 mm, and 100{\%} when considering only stones ≥3 mm. Conclusion: Contrast-enhanced CT is highly sensitive for the detection of renal stones ≥3 mm in diameter and less sensitive for smaller stones. In cases where the clinical diagnosis is uncertain and performance of a CT examination is being contemplated, intravenous contrast utilization would allow assessment for stone disease while also optimizing evaluation for other conditions.",
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T1 - Renal stones on portal venous phase contrast-enhanced CT

T2 - Does intravenous contrast interfere with detection?

AU - Dym, R. Joshua

AU - Duncan, Dameon R.

AU - Spektor, Michael

AU - Cohen, Hillel W.

AU - Scheinfeld, Meir H.

PY - 2014

Y1 - 2014

N2 - Purpose: To determine the sensitivity of portal venous phase contrast-enhanced CT for the detection of renal stones. Methods: This retrospective study included 97 CT examinations of the abdomen without and with intravenous contrast, including 85 (87.6%) examinations with at least one renal stone on the "gold standard" noncontrast images, as scored by a single radiologist. Three other radiologists each independently reviewed only the contrast-enhanced images from all 97 examinations and recorded all renal stones. Reviewer sensitivity for stones was categorized by stone diameter. Reviewer sensitivity and specificity for stone disease were also calculated on a per-kidney basis. Results: The 97 cases included a total of 238 stones ≥1 mm, with a mean (±SD) of 1.2 ± 1.9 stones per kidney and a stone diameter of 3.5 ± 3.0 mm. Pooling data for the three reviewers, sensitivity for all stones was 81%; sensitivity for stones ≥2, ≥3, ≥4, and ≥5 mm was 88%, 95%, 99%, and 98%, respectively. Sensitivity for stone disease on a per-kidney basis was 94% when considering all stones; when considering only stones ≥2, ≥3, and ≥4 mm, sensitivity was 96%, 99%, and 100%, respectively. Specificity for stone disease on a per-kidney basis was 98% overall, 99% when considering only stones ≥2 mm, and 100% when considering only stones ≥3 mm. Conclusion: Contrast-enhanced CT is highly sensitive for the detection of renal stones ≥3 mm in diameter and less sensitive for smaller stones. In cases where the clinical diagnosis is uncertain and performance of a CT examination is being contemplated, intravenous contrast utilization would allow assessment for stone disease while also optimizing evaluation for other conditions.

AB - Purpose: To determine the sensitivity of portal venous phase contrast-enhanced CT for the detection of renal stones. Methods: This retrospective study included 97 CT examinations of the abdomen without and with intravenous contrast, including 85 (87.6%) examinations with at least one renal stone on the "gold standard" noncontrast images, as scored by a single radiologist. Three other radiologists each independently reviewed only the contrast-enhanced images from all 97 examinations and recorded all renal stones. Reviewer sensitivity for stones was categorized by stone diameter. Reviewer sensitivity and specificity for stone disease were also calculated on a per-kidney basis. Results: The 97 cases included a total of 238 stones ≥1 mm, with a mean (±SD) of 1.2 ± 1.9 stones per kidney and a stone diameter of 3.5 ± 3.0 mm. Pooling data for the three reviewers, sensitivity for all stones was 81%; sensitivity for stones ≥2, ≥3, ≥4, and ≥5 mm was 88%, 95%, 99%, and 98%, respectively. Sensitivity for stone disease on a per-kidney basis was 94% when considering all stones; when considering only stones ≥2, ≥3, and ≥4 mm, sensitivity was 96%, 99%, and 100%, respectively. Specificity for stone disease on a per-kidney basis was 98% overall, 99% when considering only stones ≥2 mm, and 100% when considering only stones ≥3 mm. Conclusion: Contrast-enhanced CT is highly sensitive for the detection of renal stones ≥3 mm in diameter and less sensitive for smaller stones. In cases where the clinical diagnosis is uncertain and performance of a CT examination is being contemplated, intravenous contrast utilization would allow assessment for stone disease while also optimizing evaluation for other conditions.

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KW - CT

KW - Emergency imaging

KW - Intravenous contrast

KW - Iodinated contrast

KW - Renal stones

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