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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Autores principales: Reimer, Robert Peter, Klein, Konstantin, Rinneburger, Miriam, Zopfs, David, Lennartz, Simon, Salem, Johannes, Heidenreich, Axel, Maintz, David, Haneder, Stefan, Große Hokamp, Nils
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361194/
https://www.ncbi.nlm.nih.gov/pubmed/34385563
http://dx.doi.org/10.1038/s41598-021-95962-z
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author Reimer, Robert Peter
Klein, Konstantin
Rinneburger, Miriam
Zopfs, David
Lennartz, Simon
Salem, Johannes
Heidenreich, Axel
Maintz, David
Haneder, Stefan
Große Hokamp, Nils
author_facet Reimer, Robert Peter
Klein, Konstantin
Rinneburger, Miriam
Zopfs, David
Lennartz, Simon
Salem, Johannes
Heidenreich, Axel
Maintz, David
Haneder, Stefan
Große Hokamp, Nils
author_sort Reimer, Robert Peter
collection PubMed
description 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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spelling pubmed-83611942021-08-17 Manual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings Reimer, Robert Peter Klein, Konstantin Rinneburger, Miriam Zopfs, David Lennartz, Simon Salem, Johannes Heidenreich, Axel Maintz, David Haneder, Stefan Große Hokamp, Nils Sci Rep Article 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. Nature Publishing Group UK 2021-08-12 /pmc/articles/PMC8361194/ /pubmed/34385563 http://dx.doi.org/10.1038/s41598-021-95962-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Reimer, Robert Peter
Klein, Konstantin
Rinneburger, Miriam
Zopfs, David
Lennartz, Simon
Salem, Johannes
Heidenreich, Axel
Maintz, David
Haneder, Stefan
Große Hokamp, Nils
Manual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings
title 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_short 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
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361194/
https://www.ncbi.nlm.nih.gov/pubmed/34385563
http://dx.doi.org/10.1038/s41598-021-95962-z
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