Ultrasound versus CT for Diagnosis of Kidney Stones: A Systematic Review and Meta-Analysis

Abstract

Background: Kidney stone disease is a common urological problem that calls for quick diagnosis and intervention and it needs a definitive and reliable imaging modality. Computed tomography has been regarded as the benchmark imaging modality in stone detection because of its accuracy, but there is increasing focus on the ultrasonogram because of the worries for the radiation exposure. Even though in widespread clinical application, the variations in the ultrasound diagnostic accuracy as compare to CT scan are a matter of concern.

Objective: The current systematic review and meta-analysis intended to compare the efficacies of ultrasonography versus CT in detecting renal calculi based on sensitivity, specificity and overall clinical usefulness in various patient populations.

Methods: A comprehensive search was performed on the electronic databases PubMed/MEDLINE Scopus Web of Science, and Google Scholar to identify research articles investigating the diagnostic ability of ultrasound and computed tomography for nephrolithiasis. The studies of both adult and pediatric populations were reviewed for exclusion and inclusion criteria. Data was collected and collated on study design, study population, and diagnostic results. Data was evaluated for quality with the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool and quantitative synthesis was used to calculate pooled estimates.

Results: Eight studies with a combined total of 2,439 patients were included in the review. The results suggested that computed tomography had better diagnostic accuracy than ultrasonography in evaluation of renal calculi. The combined sensitivity and specificity of ultrasonography were 78.4% and 89.6%, respectively. In comparison, the combined sensitivity and specificity of CT were 96.8% and 98.2%, respectively. Ultrasound was less sensitive at detecting smaller stones and stones in difficult to visualize anatomical regions. Still, ultrasound still proved to be a useful modality in clinical practice due to its noninvasive nature and lack of radiation, which is Most of all desirable in situations where patients are Children, Pregnant or require multiple follow-up images. There was moderate heterogeneity seen when combining the results from the included studies.

Conclusion: Computer tomography continues to be the most accurate imaging modality for the diagnosis of kidney stones and about this has superior performance compared with ultrasound. Still, ultrasound remains an important modality at present as a first line and surveillance imaging tool, Most of all in populations in whom unnecessary radiation should be avoided. Future developments and more prospective studies are needed to better optimize diagnostic strategies.