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Computed tomography window affects kidney stones measurements.

Alexandre Danilovic1, Bruno Aragão Rocha2, Giovanni Scala Marchini1

  • 1Departamento de Urologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil.

International Braz J Urol : Official Journal of the Brazilian Society of Urology
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PubMed
Summary

Non-contrast computed tomography (NCCT) stone measurements differ between bone and soft tissue windows. Soft tissue windows overestimate stone size and volume, potentially impacting clinical decisions for kidney stones.

Keywords:
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Area of Science:

  • Urology
  • Radiology
  • Medical Imaging

Background:

  • Non-contrast computed tomography (NCCT) is crucial for evaluating kidney stones.
  • Stone measurements can vary based on NCCT window settings.
  • Accurate stone measurement is vital for treatment planning, particularly for retrograde intrarenal surgery (RIRS).

Purpose of the Study:

  • To compare kidney stone measurements between NCCT bone and soft tissue windows.
  • To evaluate the impact of different NCCT windows on stone size, volume, and density.
  • To assess potential discrepancies in residual fragment classification after RIRS.

Main Methods:

  • NCCT scans of 92 patients (115 renal units) with kidney stones treated by RIRS were analyzed.
  • Stone measurements were performed using both magnified bone and soft tissue windows in three axes.
  • A single radiologist, blinded to other measurements, performed all evaluations.

Main Results:

  • Significant differences were observed in stone largest size (p<0.0001), volume (p<0.0001), and density (p<0.0001) between bone and soft tissue windows.
  • Soft tissue windows yielded larger measurements for stone size and volume.
  • A small percentage of renal units (5.2%) were reclassified regarding residual fragments based on the window used.

Conclusions:

  • NCCT window settings significantly influence kidney stone measurements.
  • Soft tissue windows tend to overestimate stone diameter and volume compared to bone windows.
  • These measurement variations may affect clinical decision-making and post-treatment assessment.