{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T05:54:35Z","timestamp":1792302875020,"version":"4.4.0"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,1,31]],"date-time":"2017-01-31T00:00:00Z","timestamp":1485820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Renal colic is a common clinical condition which is often investigated with a <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> of the kidneys, ureters and bladder (<jats:styled-content style=\"fixed-case\">CTKUB<\/jats:styled-content>). Recent technological improvements have allowed a reduction in dose with the emergence of low\u2010dose <jats:styled-content style=\"fixed-case\">CTKUB<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">LD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CTKUB<\/jats:styled-content>) techniques. The present meta\u2010analysis aims to determine the diagnostic accuracy of <jats:styled-content style=\"fixed-case\">LD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CTKUB<\/jats:styled-content> in the diagnosis of clinically significant uroliths. A systematic review was performed using nine electronic databases from their dates of inception to May 2016. Inclusion criteria included studies reporting comparative outcomes using <jats:styled-content style=\"fixed-case\">LD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CTKUB<\/jats:styled-content> with a dose less than 3 millisieverts compared to an imaging gold standard or clinical and surgical evaluation. The primary endpoint was detection of a urolith \u22653\u00a0mm where specified and any urolith when size was unspecified. Twelve studies were identified according to selection criteria, involving 1250 patients. <jats:styled-content style=\"fixed-case\">LD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CTKUB<\/jats:styled-content> demonstrated a pooled sensitivity of 93.1% (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 91.5\u201394.4), specificity of 96.6% (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 95.1\u201397.7%), positive likelihood ratio of 19.9 (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 12.7\u201331.2), negative likelihood ratio of 0.05 (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.02\u20130.10) and <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> of 0.9877 in the detection of clinically significant uroliths. Although 86 alternative diagnoses were noted across seven studies, none assessed the accuracy of <jats:styled-content style=\"fixed-case\">LD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CTKUB<\/jats:styled-content> in their detection. The majority of newer studies report an average radiation dose from 1 to 1.5 millisieverts. This study demonstrates a high sensitivity, specificity and positive predictive value in the detection of uroliths, however, its accuracy in the detection of alternative diagnoses is unknown. Therefore, we recommend using <jats:styled-content style=\"fixed-case\">LD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CTKUB<\/jats:styled-content> when the pre\u2010test probability of stone disease is significantly higher than the pre\u2010test probability of alternative diagnoses, such as follow\u2010up of known calculi. We suggest caution when the pre\u2010test probability of alternative diagnoses is high, such as the initial presentation of renal colic.<\/jats:p>","DOI":"10.1111\/1754-9485.12587","type":"journal-article","created":{"date-parts":[[2017,1,31]],"date-time":"2017-01-31T07:18:21Z","timestamp":1485847101000},"page":"582-590","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":79,"title":["Systematic review and meta\u2010analysis of the diagnostic accuracy of low\u2010dose computed tomography of the kidneys, ureters and bladder for urolithiasis"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4823-2890","authenticated-orcid":false,"given":"Hao","family":"Xiang","sequence":"first","affiliation":[{"name":"Department of Radiology Concord Repatriation General Hospital Sydney New South Wales 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