Manual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings

Computed tomography in suspected urolithiasis provides information about the presence, location and size of stones. Particularly stone size is a key parameter in treatment decision; however, data on impact of reformatation and measurement strategies is sparse. This study aimed to investigate the inf...

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Veröffentlicht in:Scientific reports Jg. 11; H. 1; S. 16437 - 7
Hauptverfasser: Reimer, Robert Peter, Klein, Konstantin, Rinneburger, Miriam, Zopfs, David, Lennartz, Simon, Salem, Johannes, Heidenreich, Axel, Maintz, David, Haneder, Stefan, Große Hokamp, Nils
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London Nature Publishing Group UK 12.08.2021
Nature Publishing Group
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Schlagworte:
692/4025/1861
692/699/1585/273
692/700/1421/2025
Algorithms
Anthropomorphism
Calculi
Computed tomography
Drug dosages
Humanities and Social Sciences
Humans
Image processing
Kidney Calculi - diagnostic imaging
Kidney Calculi - pathology
Kidney stones
Kidneys
Lithiasis
multidisciplinary
Nephrolithiasis
Radiation
Radiographic Image Interpretation, Computer-Assisted - methods
Science
Science (multidisciplinary)
Software
Tomography, X-Ray Computed - methods
Urinary tract diseases
Variance analysis
ISSN:2045-2322, 2045-2322
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Zusammenfassung:Computed tomography in suspected urolithiasis provides information about the presence, location and size of stones. Particularly stone size is a key parameter in treatment decision; however, data on impact of reformatation and measurement strategies is sparse. This study aimed to investigate the influence of different image reformatations, slice thicknesses and window settings on stone size measurements. Reference stone sizes of 47 kidney stones representative for clinically encountered compositions were measured manually using a digital caliper (Man-M). Afterwards stones were placed in a 3D-printed, semi-anthropomorphic phantom, and scanned using a low dose protocol (CTDI vol 2 mGy). Images were reconstructed using hybrid-iterative and model-based iterative reconstruction algorithms (HIR, MBIR) with different slice thicknesses. Two independent readers measured largest stone diameter on axial (2 mm and 5 mm) and multiplanar reformatations (based upon 0.67 mm reconstructions) using different window settings (soft-tissue and bone). Statistics were conducted using ANOVA ± correction for multiple comparisons. Overall stone size in CT was underestimated compared to Man-M (8.8 ± 2.9 vs. 7.7 ± 2.7 mm, p  < 0.05), yet closely correlated ( r  = 0.70). Reconstruction algorithm and slice thickness did not significantly impact measurements ( p  > 0.05), while image reformatations and window settings did ( p  < 0.05). CT measurements using multiplanar reformatation with a bone window setting showed closest agreement with Man-M (8.7 ± 3.1 vs. 8.8 ± 2.9 mm, p  < 0.05, r  = 0.83). Manual CT-based stone size measurements are most accurate using multiplanar image reformatation with a bone window setting, while measurements on axial planes with different slice thicknesses underestimate true stone size. Therefore, this procedure is recommended when impacting treatment decision.
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ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-021-95962-z