Document Detail


Conspicuity of renal calculi at unenhanced CT: effects of calculus composition and size and CT technique.
MedLine Citation:
PMID:  12354990     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the effects of calculus size, composition, and technique (kilovolt and milliampere settings) on the conspicuity of renal calculi at unenhanced helical computed tomography (CT). MATERIALS AND METHODS: The authors performed unenhanced CT of a phantom containing 188 renal calculi of varying size and chemical composition (brushite, cystine, struvite, weddellite, whewellite, and uric acid) at 24 combinations of four kilovolt (80-140 kV) and six milliampere (200-300 mA) levels. Two radiologists, who were unaware of the location and number of calculi, reviewed the CT images and recorded where stones were detected. These observations were compared with the known positions of calculi to generate true-positive and false-positive rates. Logistic regression analysis was performed to investigate the effects of stone size, composition, and technique and to generate probability estimates of detection. Interobserver agreement was estimated with kappa statistics. RESULTS: Interobserver agreement was high: the mean kappa value for the two observers was 0.86. The conspicuity of stone fragments increased with increasing kilovolt and milliampere levels for all stone types. At the highest settings (140 kV and 300 mA), the detection threshold size (ie, the size of calculus that had a 50% probability of being detected) ranged from 0.81 mm + 0.03 (weddellite) to 1.3 mm + 0.1 (uric acid). Detection threshold size for each type of calculus increased up to 1.17-fold at lower kilovolt settings and up to 1.08-fold at lower milliampere settings. CONCLUSION: The conspicuity of small renal calculi at CT increases with higher kilovolt and milliampere settings, with higher kilovolts being particularly important. Small uric acid calculi may be imperceptible, even with maximal CT technique.
Authors:
Mitchell E Tublin; Michael E Murphy; David M Delong; Franklin N Tessler; Mark A Kliewer
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiology     Volume:  225     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-09-30     Completed Date:  2002-10-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  91-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Albany Medical College, NY, USA. tublinme@msx.upmc.edu
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MeSH Terms
Descriptor/Qualifier:
Humans
Kidney Calculi / chemistry,  pathology,  radiography*
Logistic Models
Models, Statistical
Observer Variation
Phantoms, Imaging
Tomography, X-Ray Computed* / methods

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