Accuracy of unenhanced computerized tomography interpretation by urologists in patients with acute flank pain

The aim was to compare the findings of non-contrast computerized tomography (NCCT) evaluated by urology specialists with the findings of experienced radiologists, who are accepted as a standard reference for patients who present with acute flank pain.

Five hundred patients evaluated with NCCT were included in the study. The NCCT images of these patients were evaluated by both radiologists and urology specialists in terms of the presence of calculus, size of calculus, the location of calculus, the presence of hydronephrosis, and pathologies other than calculus, and the results were compared.

The evaluations of urology specialists and standard reference radiology specialists are consistent with each other in terms of the presence of calculus (kappa [κ]: 0.904), categorical stone size (κ: 0.81), the location of calculus (κ: 0.88), and hydronephrosis (κ: 0.94). However, the evaluations of urology specialists in detecting pathologies other than calculus, which may cause acute flank pain or accompany renal colic, were found to be inadequate (κ: 0.37). The false-negative rate of detecting pathologies outside of the urinary system by the urology specialists is calculated as 0.86.

Although the urology specialists can evaluate the findings related to calculus sufficiently with NCCT, they may not discover pathologies outside of the urinary system.