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

Abstract 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 investigat...

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Autores principales:	Robert Peter Reimer, Konstantin Klein, Miriam Rinneburger, David Zopfs, Simon Lennartz, Johannes Salem, Axel Heidenreich, David Maintz, Stefan Haneder, Nils Große Hokamp
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c3780efc8c1546768989e12f16f75c80
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spelling	oai:doaj.org-article:c3780efc8c1546768989e12f16f75c802021-12-02T19:06:44ZManual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings10.1038/s41598-021-95962-z2045-2322https://doaj.org/article/c3780efc8c1546768989e12f16f75c802021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95962-zhttps://doaj.org/toc/2045-2322Abstract 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 (CTDIvol 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.Robert Peter ReimerKonstantin KleinMiriam RinneburgerDavid ZopfsSimon LennartzJohannes SalemAxel HeidenreichDavid MaintzStefan HanederNils Große HokampNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Robert Peter Reimer Konstantin Klein Miriam Rinneburger David Zopfs Simon Lennartz Johannes Salem Axel Heidenreich David Maintz Stefan Haneder Nils Große Hokamp Manual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings
description	Abstract 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 (CTDIvol 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.
format	article
author	Robert Peter Reimer Konstantin Klein Miriam Rinneburger David Zopfs Simon Lennartz Johannes Salem Axel Heidenreich David Maintz Stefan Haneder Nils Große Hokamp
author_facet	Robert Peter Reimer Konstantin Klein Miriam Rinneburger David Zopfs Simon Lennartz Johannes Salem Axel Heidenreich David Maintz Stefan Haneder Nils Große Hokamp
author_sort	Robert Peter Reimer
title	Manual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings
title_short	Manual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings
title_full	Manual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings
title_fullStr	Manual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings
title_full_unstemmed	Manual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings
title_sort	manual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/c3780efc8c1546768989e12f16f75c80
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Manual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings

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