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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Article info
Publication history
Published online: October 13, 2017
Accepted:
October 3,
2017
Received:
August 8,
2017
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
