Radiation dose reduction for CT assessment of urolithiasis using iterative reconstruction: A prospective intra-individual study
OBJECTIVE The objective of our study was to perform a meta-analysis to evaluate the diagnostic performance of low-dose CT for the diagnosis of urolithiasis (seven studies, 1,061 patients). MATERIALS AND METHODS The medical literature from 1995 to 2007 was searched using PubMed, Medline, and Cochrane Library databases for articles on studies that used low-dose CT (< 3 mSv dose applied for the entire CT examination) as a diagnostic test for the detection of urolithiasis. Prospective and retrospective studies were included if they separately reported the rate of true-positive, true-negative, false-positive, and false-negative diagnoses of urolithiasis from low-dose CT compared with the positive and negative rates of normal-dose CT or a combination of diagnostic tests. Two readers assessed the quality of the studies. RESULTS The pooled sensitivity and specificity of low-dose CT for the diagnosis of urolithiasis were 0.966 (95% CI, 0.950-0.978) and 0.949 (95% CI, 0.920-0.970), respectively. CONCLUSION The results of this meta-analysis suggest that a low-dose CT protocol can be used as the initial imaging technique in the workup of patients with suspected urolithiasis.