Imaging in stone diagnosis and surgical planning

Radiological imaging techniques and applications are constantly advancing. This review will examine modern imaging techniques in the diagnosis of urolithiasis and applications for surgical planning.

The diagnosis of urolithiasis may be done via plain film X-ray, ultrasound (US), or contrast tomography (CT) scan. US should be applied in the workup of flank pain in emergency rooms and may reduce unnecessary radiation exposure. Low dose and ultra-low-dose CT remain the diagnostic standard for most populations but remain underutilized. Single and dual-energy CT provide three-dimensional imaging that can predict stone-specific parameters that help clinicians predict stone passage likelihood, identify ideal management techniques, and possibly reduce complications. Machine learning has been increasingly applied to 3-D imaging to support clinicians in these prognostications and treatment selection.

The diagnosis and management of urolithiasis are increasingly personalized. Patient and stone characteristics will support clinicians in treatment decision, surgical planning, and counseling.