Document Detail


Size matters: a survey of how urinary-tract stones are measured in the UK.
MedLine Citation:
PMID:  16190844     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Stone size forms the basis of management pathways in patients with urolithiasis. We carried out a questionnaire-based audit to find out how stone size is routinely measured by radiologists in the UK. MATERIALS AND METHODS: A series of 831 anonymous questionnaires concerning how stone size is assessed using four imaging modalities--plain abdominal radiograph (KUB film), intravenous urogram (IVU), ultrasound, and CT--were sent to 277 radiology departments. Following the survey, a substudy at our institution compared urologists (N = 10) and radiologists (N = 5) in estimating the size of a large (26-mm) and small (11- mm) calculus on KUB films. RESULTS: Of the questionnaires, 425 were returned, and 421 were analyzed. Of these, 85% were from consultants, 14% from trainees/middle grades, and 1% "unspecified." In total, 92% of the respondents were radiologists (10% uroradiologists) and 8% urologists. Estimation of stone size ("guestimation") from KUB films and IVUs was used by 40% and 36% of radiologists, respectively, whereas graded rulers were used by 57% and 59%, respectively. For ultrasound scans and CT, electronic measurement was the favored method (81% and 73%), but guestimation was still used by 10% and 15%, respectively. When assessing the KUB films and IVU, 59% and 61% of urologists, respectively, also used guestimation. The substudy revealed a significant difference among radiologists in the accuracy of size estimation for the 11-mm stone (mean estimated size 9.6 mm; P = 0.02, one-sample t-test). CONCLUSION: A large proportion of radiologists use guestimation for assessing stone size on KUB films and IVU. Even when electronic measuring aids were available for CT and ultrasonography, guestimates remained prevalent. Our substudy showed that radiologists significantly underestimated the smaller stone.
Authors:
Rebecca J Kampa; Khurshid R Ghani; Shahjahan Wahed; Uday Patel; Ken M Anson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  19     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-29     Completed Date:  2006-02-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  856-60     Citation Subset:  IM    
Affiliation:
Department of Urology, St. George's Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Diagnostic Imaging / methods*
Great Britain
Humans
Physician's Practice Patterns*
Questionnaires
Radiology
Urinary Calculi / pathology*
Urology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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