Increased urinary bladder volume improves the detectability of urinary stones at the ureterovesical junction in non-enhanced computed tomography (NECT)
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Increased urinary bladder volume improves the detectability of urinary stones at the ureterovesical junction in non-enhanced computed tomography (NECT). / Avanesov, Maxim; Togmat, Julja; Solmaz, Mehtap; Kaul, Michael Gerhard; Laqmani, Azien; Guerreiro, Helena; Keller, Sarah; Weisbach, Lars; Adam, Gerhard; Yamamura, Jin.
In: EUR RADIOL, Vol. 29, No. 12, 12.2019, p. 6953-6964.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Increased urinary bladder volume improves the detectability of urinary stones at the ureterovesical junction in non-enhanced computed tomography (NECT)
AU - Avanesov, Maxim
AU - Togmat, Julja
AU - Solmaz, Mehtap
AU - Kaul, Michael Gerhard
AU - Laqmani, Azien
AU - Guerreiro, Helena
AU - Keller, Sarah
AU - Weisbach, Lars
AU - Adam, Gerhard
AU - Yamamura, Jin
PY - 2019/12
Y1 - 2019/12
N2 - OBJECTIVES: To evaluate the influence of the urinary bladder volume on the detectability of urolithiasis at the ureterovesical junction (UVJ) using a low-dose CT (LD-CT) with iterative reconstruction (IR) and a standard-dose CT (SD-CT) without IR in a large cohort.METHODS: Four hundred patients (278 males (69.5%), mean 44.6 ± 14.7 years) with urolithiasis at the UVJ were investigated either by an LD-CT with IR (n = 289, 72%) or an SD-CT without IR (n = 111, 28%) protocol. The detectability of distal urolithiasis was assessed by a dichotomous assessment (definite or questionable) by two radiologists in consensus and by a quantitative analysis of the signal density distribution across a line drawn parallel to the distal ureter. Based on the resulting graph, minimum/maximum density values and mean/maximum upslopes and downslopes were derived and calculated automatically. In all patients, the total bladder volume was calculated by a slice-by-slice approach on axial CT images.RESULTS: Patients with definite stones showed significantly higher urinary bladder volumes compared to patients with questionable stones in both LD-CT and SD-CT (p < 0.01). These results were independent of stones' length and patients' BMI values. Using cutoffs of 92 ml for LD-CT and 69 ml for SD-CT, high positive predictive values/accuracy rates of 96%/85% (LD-CT) and 98%/86% (SD-CT) were observed to identify definite urinary stones.CONCLUSIONS: Urinary bladder volume has a significant impact on the detectability of distal urolithiasis. Moderate bladder filling by pre-CT hydration with subsequent CT scan at the time of high urge to void increases the detectability of urinary stones at the UVJ in clinical routine.KEY POINTS: • Urinary bladder volume significantly affects the detectability of distal urolithiasis • Higher bladder volumes are associated with improved detectability of distal urinary stones • Oral pre-CT hydration for urolithiasis is easily applicable and cost-effective.
AB - OBJECTIVES: To evaluate the influence of the urinary bladder volume on the detectability of urolithiasis at the ureterovesical junction (UVJ) using a low-dose CT (LD-CT) with iterative reconstruction (IR) and a standard-dose CT (SD-CT) without IR in a large cohort.METHODS: Four hundred patients (278 males (69.5%), mean 44.6 ± 14.7 years) with urolithiasis at the UVJ were investigated either by an LD-CT with IR (n = 289, 72%) or an SD-CT without IR (n = 111, 28%) protocol. The detectability of distal urolithiasis was assessed by a dichotomous assessment (definite or questionable) by two radiologists in consensus and by a quantitative analysis of the signal density distribution across a line drawn parallel to the distal ureter. Based on the resulting graph, minimum/maximum density values and mean/maximum upslopes and downslopes were derived and calculated automatically. In all patients, the total bladder volume was calculated by a slice-by-slice approach on axial CT images.RESULTS: Patients with definite stones showed significantly higher urinary bladder volumes compared to patients with questionable stones in both LD-CT and SD-CT (p < 0.01). These results were independent of stones' length and patients' BMI values. Using cutoffs of 92 ml for LD-CT and 69 ml for SD-CT, high positive predictive values/accuracy rates of 96%/85% (LD-CT) and 98%/86% (SD-CT) were observed to identify definite urinary stones.CONCLUSIONS: Urinary bladder volume has a significant impact on the detectability of distal urolithiasis. Moderate bladder filling by pre-CT hydration with subsequent CT scan at the time of high urge to void increases the detectability of urinary stones at the UVJ in clinical routine.KEY POINTS: • Urinary bladder volume significantly affects the detectability of distal urolithiasis • Higher bladder volumes are associated with improved detectability of distal urinary stones • Oral pre-CT hydration for urolithiasis is easily applicable and cost-effective.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Algorithms
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Organ Size
KW - Radiation Dosage
KW - Radiologists
KW - Retrospective Studies
KW - Tomography, X-Ray Computed/methods
KW - Ureter/diagnostic imaging
KW - Urinary Bladder/diagnostic imaging
KW - Urinary Calculi/diagnostic imaging
KW - Urolithiasis/diagnostic imaging
KW - Young Adult
U2 - 10.1007/s00330-019-06279-5
DO - 10.1007/s00330-019-06279-5
M3 - SCORING: Journal article
C2 - 31209621
VL - 29
SP - 6953
EP - 6964
JO - EUR RADIOL
JF - EUR RADIOL
SN - 0938-7994
IS - 12
ER -
