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Updated: May 9, 2026

Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition
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Published on: June 21, 2024

Lithiasis size estimation variability depending on image technical methodology.

Enrique Argüelles Salido1, Jesús Aguilar García, Jose María Lozano-Blasco

  • 1Hospital Universitario Virgen del Rocío, Sevilla, Spain, earguelles@telefonica.net.

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|August 6, 2013
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Summary

Accurate lithiasic size measurement is crucial for treatment selection. Computerized axial tomography (CT) scans using a bone window offer the most precise in vitro estimation of lithiasic size compared to plain radiography.

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Area of Science:

  • Urology
  • Medical Imaging
  • Nephrology

Background:

  • Accurate lithiasic size determination is vital for selecting appropriate surgical or medical treatments.
  • Current methods for measuring lithiasic size lack standardization, impacting treatment decisions.

Purpose of the Study:

  • To compare estimated lithiasic sizes from plain radiography and computerized axial tomography (CT) scans (using different techniques) against actual sizes.
  • To identify the optimal imaging modality for reliable lithiasic size assessment.

Main Methods:

  • An in vitro model using 245 lithiases was employed, with measurements taken using a calibrator, plain X-ray, and CT scans (bone and soft tissue windows).
  • Surface area (cm²) for radiography and surface area/volume (cm³) for CT were determined.
  • Measurements were performed by three independent researchers unaware of each other's results; statistical analysis used the Wilcoxon sign test.

Main Results:

  • CT scans in bone window slightly overestimated lithiasic volume (0.12 vs. 0.17 cm³), while soft tissue window significantly overestimated it (0.12 vs. 0.21 cm³).
  • No significant difference was found between actual surface size and bone window CT scan surface size (0.39 vs. 0.36/0.37 cm²).
  • Plain radiography underestimated surface size (0.39 vs. 0.37 cm²), and soft tissue window CT slightly overestimated it (0.42/0.44 cm²).

Conclusions:

  • Computerized axial tomography (CT) using a bone window provides the most accurate in vitro estimation of lithiasic size, despite potential overestimation of the craniocaudal diameter.
  • Soft tissue window CT scans tend to overestimate lithiasic size.
  • Plain radiography underestimates lithiasic size.