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Two- and three-dimensional CT measurements of urinary calculi length and width: a comparative study
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Kliniskt forskningscentrum (KFC), Univeritetssjukhuset, Örebro, Sverige.ORCID iD: 0000-0002-8351-3367
Örebro University, School of Science and Technology.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0003-3253-8967
(English)Manuscript (preprint) (Other academic)
Abstract [en]

The standard imaging procedure for a patient presenting with renal colic is unenhanced CT. The CT measured size has a close correlation to the estimated prognosis for spontaneous passage of a ureteral calculus. Size estimations of urinary calculi in CT images are still based on 2d-reformats. In the present study we developed and validated a calculus oriented 3dmethod for measurements of length and width of urinary calculi and compared those with corresponding 2d measurements in axial and coronal reformats.

Methods: Fifty unenhanced CT examinations demonstrating urinary calculi were included. A 3d-symmetric segmentation algorithm was validated against reader size estimations. The calculus-oriented size from the segmentation was then compared to the size in axial and coronal reformats.

Results: The validation showed 0.1±0.7 mm agreement against reference measure. There was a 0.4 mm median bias for 3d-estimated calculus length compared to 2d (p<0.001), but no significant bias for 3d-width compared to 2d.

Conclusion: The size of the urinary calculus becomes underestimated if its orientation is not aligned to the axial or coronal image plane. Future studies aiming to correlate calculus size with patient outcome should use a calculus oriented size estimation.

Keywords [en]
3D segmentation; tomography, X-ray computed; image perception; imaging, three- dimensional; image segmentation; image visualization; ureteral calculi; urinary stones; urolithiasis
National Category
Radiology, Nuclear Medicine and Medical Imaging
Research subject
Radiology
Identifiers
URN: urn:nbn:se:oru:diva-30364OAI: oai:DiVA.org:oru-30364DiVA, id: diva2:643943
Available from: 2013-08-29 Created: 2013-08-29 Last updated: 2017-10-17Bibliographically approved
In thesis
1. The stack mode review of volumetric datasets: applications for urinary stone disease
Open this publication in new window or tab >>The stack mode review of volumetric datasets: applications for urinary stone disease
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

During the last decades the acquisition and visualization of radiological images have rapidly evolved. The increasing amounts of volumetric image data particularly from modern CT systems necessitate a constant evolution of the radiological visualization techniques.

The dominating display mode for volumetric images has been the stack mode display since its introduction in computerized image review. In the increasing amounts of image data, the stack mode display needs to be analyzed so that the information content in the high resolution datasets can be transformed into clinically relevant information for the management of the individual patient. In the present thesis some aspects of the stack mode display were analyzed using for the most part the size estimation of urinary stones in unenhanced CT as a model.

The estimated size has an important correlation to the prognosis for spontaneous passage of an obstructing ureteral stone. In the present thesis the reader variations in the size estimation of urinary stones were quantified, using different visualization parameters and after an attempt to reduce the variations with a training session for the readers. The influence on the estimated stone size of CT image post processing parameters was quantified. A segmentation algorithm was developed and demonstrated to reduce the reader variability through reader independent computer aid. One limitation of the stack mode display concerns three-dimensional shapes, which was modeled by a comparison between the estimated length and width of urinary stones in two- and three-dimensional segmentation. The increasing number of image slices in the acquisitions introduces a need for efficient navigation of the image volumes. In the present thesis the navigation of CT datasets using different user interface devices was evaluated.

The rapid evolution of the MRI and CT systems necessitates a constant refinement and evaluation of the cornerstone for radiological volumetric reviewing – the stack mode display of volumetric datasets.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2013. p. 61
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 91
Keywords
stack mode display, image visualization, image perception, computed tomography, urinary stones, urolithiasis, PACS
National Category
Radiology, Nuclear Medicine and Medical Imaging
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-30324 (URN)978-91-7668-948-6 (ISBN)
Public defence
2013-10-04, Bohmanssonsalen, Universitetssjukhuset i Örebro, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2013-08-26 Created: 2013-08-26 Last updated: 2017-10-17Bibliographically approved

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Lidén, MatsThunberg, PerBroxvall, MathiasGeijer, Håkan

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