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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

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
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

Objective: to investigate the fate of indeterminate lesions incidentally found on noncontrast computed tomography (NCCT) for suspected urolithiasis.

Methods: aretrospective 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.

Adolescent, Adult, Aged, Aged, 80 and over, Cohort Studies, Contrast Media, Female, Follow-Up Studies, Humans, Incidental Findings, Kidney Calculi, Kidney Neoplasms, Male, Middle Aged, Retrospective Studies, Time Factors, Tomography, X-Ray Computed, Treatment Outcome, Ureteral Calculi, Urinary Bladder Calculi, Urolithiasis, Young Adult, Journal Article
0090-4295
1272-1274
Rai, Bhavan Prasad
e1156207-bfd1-4f89-b0aa-9e55fc54235b
Ali, Ahmed
71a2b47d-0a71-41a9-a090-0904a7803771
Raslan, Mutie
edd441e5-af6f-4c32-95e3-2adcebc6f92e
Shariffuddin, Abdul Muiz
abccade9-d072-47dd-8a21-5cb365ef62a6
Cohen, Nicholas
df34bec4-7f02-40ad-ae88-d3895a69c2ad
McClinton, Samuel
b7bd4cdb-db5e-430f-9f06-f1a680bf5e77
Somani, Bhaskar K
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Rai, Bhavan Prasad
e1156207-bfd1-4f89-b0aa-9e55fc54235b
Ali, Ahmed
71a2b47d-0a71-41a9-a090-0904a7803771
Raslan, Mutie
edd441e5-af6f-4c32-95e3-2adcebc6f92e
Shariffuddin, Abdul Muiz
abccade9-d072-47dd-8a21-5cb365ef62a6
Cohen, Nicholas
df34bec4-7f02-40ad-ae88-d3895a69c2ad
McClinton, Samuel
b7bd4cdb-db5e-430f-9f06-f1a680bf5e77
Somani, Bhaskar K
ab5fd1ce-02df-4b88-b25e-8ece396335d9

Rai, Bhavan Prasad, Ali, Ahmed, Raslan, Mutie, Shariffuddin, Abdul Muiz, Cohen, Nicholas, McClinton, Samuel and Somani, Bhaskar K (2014) 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. Urology, 84 (6), 1272-1274. (doi:10.1016/j.urology.2014.07.002).

Record type: Article

Abstract

Objective: to investigate the fate of indeterminate lesions incidentally found on noncontrast computed tomography (NCCT) for suspected urolithiasis.

Methods: aretrospective 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.

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More information

Published date: December 2014
Additional Information: Copyright © 2014 Elsevier Inc. All rights reserved.
Keywords: Adolescent, Adult, Aged, Aged, 80 and over, Cohort Studies, Contrast Media, Female, Follow-Up Studies, Humans, Incidental Findings, Kidney Calculi, Kidney Neoplasms, Male, Middle Aged, Retrospective Studies, Time Factors, Tomography, X-Ray Computed, Treatment Outcome, Ureteral Calculi, Urinary Bladder Calculi, Urolithiasis, Young Adult, Journal Article

Identifiers

Local EPrints ID: 419467
URI: https://eprints.soton.ac.uk/id/eprint/419467
ISSN: 0090-4295
PURE UUID: ca0bda70-a643-45a3-a5fc-c012407ec3c5

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Date deposited: 12 Apr 2018 16:30
Last modified: 13 Mar 2019 18:44

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