“ROLE OF UNENHANCED COMPUTED TOMOGRAPHY KIDNEY, URETER, BLADDER (CT KUB) IN THE DIAGNOSIS OF INCIDENTAL FINDINGS”

Main Article Content

Abdul Salam
Girma Abdeta Bogale
Dr. Qasim Yousaf
Sahar Ashraf
Dr Amjad Ali Shah
Abdul Wadood
Nazifa Tahseen
Kazim Ali
Kinza Fatima
Md Ariful Haque
Ayesha Malik
Muhammad Hashim Khan

Keywords

Incidental Findings, Genitourinary, Non-genitourinary, Gynecological, Gastrointestinal

Abstract

Introduction: Incidental findings refer to results that are irrelevant to the actual purpose of performing a diagnostic assessment. The superiority of Unenhanced Computed Tomography is that detects ureteral stones, identifies extra-urinary abnormalities, and does not require intravenous contrast.


Objectives: The objective of the study is to better understand the role of Unenhanced CT while evaluating the detection of incidental findings and to determine the medical importance of incidental findings.


Material and Method: From March 2023 to August 2023, a cross-sectional study with consecutive sampling was conducted in the radiology department of the tertiary care hospital Hayatabad Medical Complex Peshawar, Pakistan. The Institutional Research and Ethics Review Board (IREB) of the Hayatabad Medical Complex Peshawar, Pakistan gave its clearance for the study. Participants' ages ranged from 20 to 70.


Results: Of the total 320 patients, 48 (15%) patients had Incidental findings of which 30 were males and 18 were females.19 patients included the genitourinary, 28 the non-genitourinary, and 1 had both the genitourinary and non-genitourinary Incidental findings. The most frequent genitourinary findings were renal cyst 7. In contrast, the most common non-genitourinary findings were appendicitis 5, which was shown to happen most frequently in those between the ages of 20 to 29. The most affected age group was 30 to 39. ER Physician 31 sent the majority of patients to CT KUB, as compared to Urologists.


Conclusion: The number of incidental findings found by MDCT during the KUB examination for possible kidney stones was much higher than that reported in other study papers. Unenhanced computed tomography is a successful tool for identifying incidental findings and has an immense effect on how patients are managed. Radiology technologists and radiologists' knowledge, skills, and genuine interest play a critical role in diagnosing abnormalities other than kidney stones.

Abstract 220 | PDF Downloads 91

References

1. U. Siddique et al., “Unenhanced CT KUB for Urinary Colic: It’s not just about the stones,” Pakistan J. Med. Heal. Sci., vol. 14, no. 2, pp. 672–675, 2020.
2. P. Jaiswal, S. Shrestha, Y. Dwa, D. Maharjan, and N. T. Sherpa, “CT KUB evaluation of suspected urolithiasis,” J. Patan Acad. Heal. Sci., vol. 9, no. 1, pp. 58–64, 2022, doi: 10.3126/jpahs.v9i1.43895.
3. F. Ahmed et al., “The role of ultrasonography in detecting urinary tract calculi compared to CT scan,” Res. Reports Urol., vol. 10, pp. 199–203, 2018, doi: 10.2147/RRU.S178902.
4. N. I. Ali, N. E. Pasha, and R. T.H.S, “Diagnostic Accuracy of Ultrasound and Plain X-Ray KUB (Kidney, Ureter, Bladder) Compared to Non-Contrast CT (Computed Tomography) in Patients of Ureteric Calculi,” J. Evid. Based Med. Healthc., vol. 7, no. 47, pp. 2762–2766, 2020, doi: 10.18410/jebmh/2020/567.
5. A. Wadood, A. Malik, A. Salam, K. Ali, and M. Usman, “Journal of Peoples University of Medical and Health Sciences for Women (JPUMHS) TO EVALUATE THE ROLE OF CT KUB (KIDNEY, URETER, BLADDER) IN THE DETECTION OF UROLITHIASIS IN PATIENTS WITH ACUTE FLANK’S PAIN.,” J. Peoples Univ. Med. Heal. Sci. Women, vol. 13, no. 02, pp. 20–30, 2023, doi: http://doi.org/10.46536/jpumhs/2023/13.02.409.
6. M. M. Al-Shawi et al., “The Role of Radiological Imaging in the Diagnosis and Treatment of Urolithiasis: A Narrative Review,” Cureus, vol. 14, no. 12, pp. 10–15, 2022, doi: 10.7759/cureus.33041.
7. S. Kondekar and I. Minne, “Comparative Study of Ultrasound and Computerized Tomography for Nephrolithiasis Detection,” Int. J. Contemp. Med. Surg. Radiol., vol. 5, no. 2, pp. 4–7, 2020, doi: 10.21276/ijcmsr.2020.5.2.2.
8. S. Khanduri et al., “Role of Dual Energy CT Scan in Evaluation of the Chemical Composition of Renal Stones,” J. Clin. Diagnostic Res., pp. 4–7, 2020, doi: 10.7860/jcdr/2020/44098.13754.
9. J. Himelfarb, A. Lakhani, and D. Shelton, “Appropriate use of CT for patients presenting with suspected renal colic: A quality improvement study,” BMJ Open Qual., vol. 8, no. 4, pp. 1–6, 2019, doi: 10.1136/bmjoq-2018-000470.
10. M. Sarofim, A. Teo, and R. Wilson, “Management of alternative pathology detected using CT KUB in suspected ureteric colic,” Int. J. Surg., vol. 32, pp. 179–182, 2016, doi: 10.1016/j.ijsu.2016.06.047.
11. H. Shams, M. A. Riaz, H. Raziq, M. R. Khan, and G. Wali, “Diagnostic accuracy of ultrasonography versus computed tomography in patients of acute renal colic,” Pakistan J. Med. Heal. Sci., vol. 13, no. 4, pp. 918–921, 2019.
12. Ł. Dobrek, “Kidney Stone Disease With Special Regard To Drug-Induced Kidney Stones - a Contemporary Synopsis,” Wiad. Lek., vol. 73, no. 9 cz 2, pp. 2031–2039, 2020, doi: 10.36740/wlek202009226.
13. M. Nadeem, M. H. Ather, A. Jamshaid, S. Zaigham, R. Mirza, and B. Salam, “Rationale use of unenhanced multi-detector CT (CT KUB) in evaluation of suspected renal colic,” Int. J. Surg., vol. 10, no. 10, pp. 634–637, 2012, doi: 10.1016/j.ijsu.2012.10.007.
14. Y. Andrabi, M. Patino, C. J. Das, B. Eisner, D. V. Sahani, and A. Kambadakone, “Advances in CT imaging for urolithiasis,” Indian J. Urol., vol. 31, no. 3, pp. 185–193, 2015, doi: 10.4103/0970-1591.156924.
15. F. Hospital, “E f f i c a c y o f u r i n a l y s i s i n s c r e e n i n g p a t i e n t s u n d e r g o i n g c t k u b f o r s u s p e c t e d u r o l i t h i a s i s,” vol. 67, no. 6, pp. 65–68, 2017.
16. F. B. Nida Sha , Rehana Mushtaq, “Pakistan biomedical journal,” no. c, pp. 37–40, 2021.
17. M. T. Corwin, J. S. Lee, G. Fananapazir, M. Wilson, and R. Lamba, “Detection of renal stones on portal venous phase CT: Comparison of thin axial and coronal maximumintensity-projection images,” Am. J. Roentgenol., vol. 207, no. 6, pp. 1200–1204, 2016, doi: 10.2214/AJR.16.16099.
18. J. D. C. Coates and C. T. L. Wilkinson, “A radiologist’s approach to CT KUB for the urologist,” J. Clin. Urol., vol. 12, no. 3, pp. 192–204, 2019, doi: 10.1177/2051415819828547.
19. N. Rafiq, B. Rasheed, N. Naz, and N. Al Qamari, “Utility of Unenhanced CT KUB : Beyond Urolithiasis Utility of Unenhanced CT KUB : Beyond Urolithiasis,” no. June, 2023.
20. J. Pernet et al., “Prevalence of alternative diagnoses in patients with suspected uncomplicated renal colic undergoing computed tomography: a prospective study,” CJEM, vol. 17, no. 1, pp. 67–73, 2015, doi: 10.2310/8000.2013.131314.
21. F. Imran, Z. Zaman, and M. J. Iqbal, “Diagnostic Accuracy of IVU Compared to Unenhanced CT KUB for Detection of Urinary Tract Calculi,” pp. 234–239.
22. M. Farhan, S. Anees, M. Aftab, K. Zia, and A. Qayum, “Utilization of Non-contrast Enhanced CT KUB in Patients with Suspected Renal Colic,” Pakistan J. Med. Heal. Sci., vol. 15, no. 12, pp. 3737–3740, 2021, doi: 10.53350/pjmhs2115123737.
23. M. A. Bhuiyan, S. Islam, N. Sultana, S. C. Das, and T. Islam, “Role of Non-Contrast CT Scan in the Diagnosis of Urolithiasis and Incidental Findings,” vol. 6, no. 3, pp. 58–62, 2020, doi: 10.21276/ijmrp.2020.6.3.013.
24. D. N. A. M. S. . KHALED I. ELSHAFEY, M.D. and H. M. A. M. D. . ALSHYMAA Z. ALSHAHAWY, M.D., “Comparision between Low-Dose CT and Ultrasound in Diagnosis of Renal and Uretral Stones in Adults,” Med. J. Cairo Univ., vol. 87, no. 12, pp. 4671–4677, 2019, doi: 10.21608/mjcu.2019.80829.

Most read articles by the same author(s)