Diagnostic Accuracy of Low Dose CT-KUB and Conventional Computed Tomography in Detecting Renal and Ureteric Calculi in Paediatric Patients
DOI:
https://doi.org/10.70749/ijbr.v4i3.2972Keywords:
Computed Tomography, Kidney, Urinary Bladder, Diagnostic Accuracy, Specificity, Sensitivity, Positive Predictive Value, Negative Predictive Value.Abstract
Background: Renal and ureteric calculi, also referred to as kidney stones, are becoming increasingly common in the pediatric population, especially in countries such as Pakistan. Timely and accurate diagnosis is very important in preventing complications through an early diagnosis. The gold standard for the diagnosis of urolithiasis is conventional CT-KUB (Computed Tomography of Kidneys, Ureters, and Bladder) because this method has a high specificity and sensitivity. Nonetheless, constant exposure to ionizing radiation among children is dangerous to their health. Thus, low dose CT-KUB protocols have been developed to lower the radiation dose while maintaining the diagnostic accuracy. Objective: To identify the diagnostic accuracy of low-dose CT-KUB in identifying renal and ureteric calculi in children using conventional Computed Tomography as a gold standard. Methodology: This cross-sectional analytical study was conducted at the Department of Radiology, University of Child Health Sciences and Children Hospital, Lahore. Non-probability consecutive sampling was used to sample 45 pediatric patients (1 day to 16years) with history of urinary stones. Following informed consent and clinical judgment, every patient was subjected to low dose CT-KUB (<3.5 mSv) and standard CT. The same radiologist interpreted the findings. The Sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of low-dose CT-KUB will be determined by using SPSS version 26 by comparing the findings with those of conventional CT as the reference standard. Results: Diagnostic performance of low-dose CT-KUB was found to be highly preferable as compared to the conventional CT in children. The total diagnostic capability of LDCT was 93, sensitivity was 96, specificity was 95, positive predictive value was 96 and negative predictive value was 95. LDCT displayed a better correlation with the standard CT in determining the size of the stone, its number, and position within the pelvis as well as the ureter. Conclusion: CT-KUB at low doses is a reliable and precise method of imaging in identifying renal and ureteric calculi among children. It has a diagnostic accuracy that is similar to standard CT and has a much lower radiation exposure. Consequently, LDCT-KUB is a safe imaging method that can be suggested as a choice when making a diagnosis and following up on children with urolithiasis.
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