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

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

Research output: Contribution to journalArticle

Abstract

Background: Renal colic is common, and CT is frequently utilized when the diagnosis of kidney stones 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. Methods: In conjunction with the American College of Emergency Physicians (ACEP) eQual network, we formed a nine-member panel with three physician representatives each from ACEP, the ACR, and the American Urology Association. A systematic literature review was used as the basis for a three-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 12 (45%). 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)1132-1143
Number of pages12
JournalJournal of the American College of Radiology
Volume16
Issue number9
DOIs
StatePublished - Sep 1 2019

Fingerprint

Renal Colic
Consensus
Physicians
Kidney Calculi
Urology
Ionizing Radiation
Emergencies
Radiation

Keywords

  • CT
  • imaging
  • reduced radiation CT
  • renal colic
  • ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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

In: Journal of the American College of Radiology, Vol. 16, No. 9, 01.09.2019, p. 1132-1143.

Research output: Contribution to journalArticle

Moore, CL, Carpenter, CR, Heilbrun, ME, 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', Journal of the American College of Radiology, vol. 16, no. 9, pp. 1132-1143. https://doi.org/10.1016/j.jacr.2019.04.004
Moore, Christopher L. ; Carpenter, Christopher R. ; Heilbrun, Marta E. ; 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: Journal of the American College of Radiology. 2019 ; Vol. 16, No. 9. pp. 1132-1143.
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