Can computed tomography in the protocol for renal colic be interpreted by urologists?

Abstract

To examine the ability of urologists to independently (with no radiology consultation) interpret non-contrast-enhanced spiral computed tomography (CT) in patients with acute renal colic. One hundred consecutive patients presenting to the emergency department with suspected renal colic and evaluated with non-contrast spiral CT were retrospectively reviewed. The CT films of each patient were assessed separately by a first-year urology registrar and by a consultant urologist (neither of whom were subspecialized in uroradiology or endourology). The acute presentation details were provided to mimic the emergency situation. Ureteric calculi causing acute renal colic were evident in 54 patients. The consultant radiologist reported 51 ureteric calculi, and had a sensitivity, specificity and positive predictive value of 94.5%, 100% and 100%, respectively. The consultant urologist correctly identified 52 calculi, with sensitivity, specificity and positive predictive values of 96.3%, 82.7% and 86.7%. The urology registrar detected 51 stones with sensitivity, specificity and positive predictive values of 94.5%, 93.5% and 94.5%, respectively. Non-contrast spiral CT in patients with acute renal colic is an effective diagnostic tool which allows rapid and accurate evaluation of the urinary tract, thereby facilitating the acute management of patients with renal colic.