Imaging in Suspected Renal Colic: Systematic Review of the Literature and Multispecialty Consensus

Christopher L. Moore, Christopher R. Carpenter, Marta L. Heilbrun, Kevin Klauer, Amy Krambeck, Courtney Moreno, Erick M. Remer, Charles Scales, Melissa M. Shaw, Kevan M. Sternberg

Research output: Contribution to journalArticle

Abstract

PURPOSE: Renal colic is common and CT (computerized tomography) is frequently utilized when the diagnosis of kidney stone is suspected. CT is accurate, but exposes patients to ionizing radiation and has not been shown to alter either interventional approaches or hospital admission rates. This multi-organizational transdisciplinary collaboration sought evidence-based, multispecialty consensus on optimal imaging across different clinical scenarios in patients with suspected renal colic in the acute setting. MATERIALS AND METHODS: In conjunction with the ACEP (American College of Emergency Physicians®) E-QUAL (Emergency Quality Network) we formed a nine-member panel with three physician representatives each from the ACEP, the ACR® (American College of Radiology) and the AUA (American Urological Association). A systematic literature review was used as the basis for a 3-step modified Delphi process to seek consensus on optimal imaging in 29 specific clinical scenarios. RESULTS: From an initial search yielding 6,337 records there were 232 relevant articles of acceptable evidence quality to guide the literature summary. At the completion of the Delphi process consensus, agreement was rated as perfect in 15 (52%), excellent in 8 (28%), good in 3 (10%) and moderate in 3 (10%) of the 29 scenarios. There were no scenarios where at least moderate consensus was not reached. CT was recommended in 7 scenarios (24%) with ultrasound in 9 (31%) and no further imaging needed in 13 (45%). CONCLUSIONS: Evidence and multispecialty consensus support ultrasound or no further imaging in specific clinical scenarios, with reduced-radiation dose CT to be employed when CT is needed in patients with suspected renal colic.

Original languageEnglish (US)
Pages (from-to)475-483
Number of pages9
JournalThe Journal of urology
Volume202
Issue number3
DOIs
StatePublished - Sep 1 2019

Fingerprint

Renal Colic
Consensus
Tomography
Emergencies
Physicians
Kidney Calculi
Ionizing Radiation
Radiology
Radiation

Keywords

  • diagnostic imaging
  • kidney calculi
  • renal colic
  • tomography
  • ultrasonography
  • x-ray computed

ASJC Scopus subject areas

  • Urology

Cite this

Moore, C. L., Carpenter, C. R., Heilbrun, M. L., Klauer, K., Krambeck, A., Moreno, C., ... Sternberg, K. M. (2019). Imaging in Suspected Renal Colic: Systematic Review of the Literature and Multispecialty Consensus. The Journal of urology, 202(3), 475-483. https://doi.org/10.1097/JU.0000000000000342

Imaging in Suspected Renal Colic : Systematic Review of the Literature and Multispecialty Consensus. / Moore, Christopher L.; Carpenter, Christopher R.; Heilbrun, Marta L.; Klauer, Kevin; Krambeck, Amy; Moreno, Courtney; Remer, Erick M.; Scales, Charles; Shaw, Melissa M.; Sternberg, Kevan M.

In: The Journal of urology, Vol. 202, No. 3, 01.09.2019, p. 475-483.

Research output: Contribution to journalArticle

Moore, CL, Carpenter, CR, Heilbrun, ML, Klauer, K, Krambeck, A, Moreno, C, Remer, EM, Scales, C, Shaw, MM & Sternberg, KM 2019, 'Imaging in Suspected Renal Colic: Systematic Review of the Literature and Multispecialty Consensus', The Journal of urology, vol. 202, no. 3, pp. 475-483. https://doi.org/10.1097/JU.0000000000000342
Moore, Christopher L. ; Carpenter, Christopher R. ; Heilbrun, Marta L. ; Klauer, Kevin ; Krambeck, Amy ; Moreno, Courtney ; Remer, Erick M. ; Scales, Charles ; Shaw, Melissa M. ; Sternberg, Kevan M. / Imaging in Suspected Renal Colic : Systematic Review of the Literature and Multispecialty Consensus. In: The Journal of urology. 2019 ; Vol. 202, No. 3. pp. 475-483.
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