{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:11:17Z","timestamp":1792073477964,"version":"4.4.0"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,8,17]],"date-time":"2016-08-17T00:00:00Z","timestamp":1471392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To determine the sensitivity and specificity of ultrasonography (\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      ) for detecting renal calculi and to assess the accuracy of\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      for determining the size of calculi and how this can affect counselling decisions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively identified all patients at our institution with a diagnosis of nephrolithiasis who underwent\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      followed by non\u2010contrast computed tomography (\n                      <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\n                      ) within 60 days. Data on patient characteristics, stone size (maximum axial diameter) and stone location were collected. The sensitivity, specificity and size accuracy of\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      was determined using\n                      <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\n                      as the standard.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 552\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\n                      examinations met the inclusion criteria. Overall, the sensitivity and specificity of\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      was 54 and 91%, respectively. There was a significant association between sensitivity of\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      and stone size (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), but not with stone location (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.58).\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      significantly overestimated the size of stones in the 0\u201310 mm range (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Assuming patients with stones 0\u20134 mm in size will be selected for observation and those with stones \u22655 mm could be counselled on the alternative of intervention, we found that in 14% (54\/384) of cases where\n                      <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\n                      would suggest observation,\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      would lead to a recommendation for intervention. By contrast, when\n                      <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\n                      results would suggest intervention as management,\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      would suggest observation in 39% (65\/168) of cases. An average of 22% (119\/552) of patients could be inappropriately counselled. Stones classified as 5\u201310 mm according to\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      had the highest probability (43% [41\/96]) of having their management recommendation changed when\n                      <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\n                      was performed. The use of plain abdominal film of kidney, ureter and bladder and\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      increases sensitivity (78%), but 37% (13\/35) of patients may still be counselled inappropriately to undergo observation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Using\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      to guide clinical decision\u2010making for residual or asymptomatic calculi is limited by low sensitivity and inability to size the stone accurately. As a result, one in five patients may be inappropriately counselled when using\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      alone.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.13605","type":"journal-article","created":{"date-parts":[[2016,7,26]],"date-time":"2016-07-26T10:12:58Z","timestamp":1469527978000},"page":"464-469","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":80,"title":["Accuracy of ultrasonography for renal stone detection and size determination: is it good enough for management decisions?"],"prefix":"10.1111","volume":"119","author":[{"given":"Vishnu","family":"Ganesan","sequence":"first","affiliation":[{"name":"Glickman Urological Kidney Institute Cleveland Clinic Cleveland OH USA"},{"name":"Lerner College of Medicine Cleveland Clinic Cleveland OH 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