Fate of Indeterminate Lesions Detected on Noncontrast Computed Tomography Scan for Suspected Urolithiasis: A Retrospective Cohort Study With a Minimum Follow-up of 15 Months
| Autor: | Bhavan Prasad Rai, Mutie Raslan, Nicholas Cohen, Abdul Muiz Shariffuddin, Samuel McClinton, Bhaskar K. Somani, Ahmed Ali |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Ureteral Calculi Adolescent Urology Patient demographics Contrast Media Computed tomography Cohort Studies Kidney Calculi Young Adult Urolithiasis medicine Humans Clinical significance Renal colic Aged Retrospective Studies Aged 80 and over Incidental Findings Urinary Bladder Calculi Retrospective review medicine.diagnostic_test business.industry Retrospective cohort study Mean age Middle Aged Kidney Neoplasms Surgery Treatment Outcome Female Radiology medicine.symptom Tomography X-Ray Computed business Indeterminate Follow-Up Studies |
| Zdroj: | Urology. 84:1272-1274 |
| ISSN: | 0090-4295 |
| Popis: | Objective To investigate the fate of indeterminate lesions incidentally found on noncontrast computed tomography (NCCT) for suspected urolithiasis. Methods A retrospective review of 404 consecutive cases of suspected urolithiasis was undertaken between May 2010 and April 2011. Data were collected for patient demographics, presence of calculus disease, and additional urologic or nonurologic pathologies and their clinical relevance. The indeterminate or suspicious lesions were followed up and the data were reviewed in September 2012. Results In total, 404 patients underwent NCCT for renal colic (mean age, 50 years [range, 13-91 years]; 165 females). Minimum follow-up period was 15 months. Fifty-eight patients (14%) had ureteric, 85 (21%) had renal, and 39 patients (10%) had combined ureteric and renal stones. Noncalculus pathologies were found in 107 patients (26%). Sixty patients (15%) had indeterminate lesions. Of these patients, 6 required operative intervention, 35 had a benign diagnosis after further imaging and multidisciplinary team meeting, and 13 remained under surveillance after 1 year. Indeterminate pulmonary lesions (8 of 16) were the commonest lesions to remain under surveillance. Conclusion NCCT is vital for the diagnosis of urolithiasis with a pick up rate of 45% and remains the standard of care. However, with incidental detection of potential malignant lesions, a significant minority will need close monitoring, intervention, or both. In our study, approximately one-third of these lesions either remained under surveillance or had intervention. |
| Databáze: | OpenAIRE |
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