Evaluating the Diagnostic Accuracy of Ultrasound Urolithiasis in the Community and in Hospital: a 12 Month Study: John Withington
As of now, the gold standard for the diagnosis of upper tract calculi remains CT KUB. However, ultrasound has increasing importance in terms of diagnosis, particularly in many nearby community centers. With frequent false positive scans grabbing their attention, Dr. Withington and colleagues performed a retrospective review of all patients who underwent both CT KUB and ultrasound in 2014.
An arbitrary time frame was set at 90 days between USS and CT, and electronic records were checked for any potential intervention during this time frame. 283 adult patients were included in their study, with a combined 703 scans (373 ultrasound and 330 CT KUB). Within the ultrasound cohort, 33 of the scans were performed at nearby community centers. 157 patients were diagnosed with urolithiasis from CT KUB.
Their findings were comparable with the existing literature, demonstrating positive and negative predictive values of 75.00% and 65.38%. However, specificity was considerable lower for ultrasounds performed at surrounding community centers. From this review, the authors concluded that increased outreach and training with outlying community centers would prove beneficial towards improving the specificity of ultrasound, in order to avoid additional referral in the future.
Presented by John Withington at the 2015 World Congress of Endourology Annual Meeting – October 1-4, 2015, London, United Kingdom.
Written by Austin Drysch for UroToday.com