Methodology of peri-operative imaging data reporting for stone disease: a systematic review toward the development of...

To critically analyze the methodology of imaging data reporting, including timing, modality and stone burden measurement perioperatively, from recently published literature on surgical interventions for stones, and to develop a scoring system to evaluate its quality.

Articles reporting treatment outcomes in adult patients, published in 2020-2021 by preselected journals, were searched on PubMed and Embase. Recorded data for statistical analysis included type of study and intervention, pre- and postoperative imaging modality and timing, stone burden assessment method and measurement, stone free and treatment success definition or their differentiation. A new 7-point checklist (iSTAR-Imaging for Stone Treatment Assessment Reporting) was developed.

A total of 122 studies were included. Several papers did not report on pre- or postoperative imaging modality (13.9% and 5.7%), nor provided a definition of stone burden measurement or treatment success (43% and 18%). Stone burden was most often assessed with Non-Contrast Computed Tomography (54.9%) and reported as stone diameter (75.4%). Definitions of treatment success varied widely across literature, ranging from 0 mm to allowing 4 mm residual fragments. Preoperative imaging timing lacked in 95.9% of studies, while postoperative timing distribution was heterogeneously present. iSTAR scores resulted in 0/7 (0.8%), 1/7 (0.8%), 2/7 (1.6%), 3/7 (7.4%), 4/7 (16.4%), 5/7 (32%), 6/7 (38.5%) and 7/7 (10.7%), independently from study design.

This research unveils a lack of standardization in reporting of perioperative urolithiasis imaging. iSTAR checklist may help authors to improve data reporting and provide journals and reviewers with a framework to assess imaging methodology quality in submitted manuscripts.