Optimising Imaging Strategies in Suspected Urolithiasis:  Effects on Diagnostic and Therapeutic Timelines

Mertcan Dama; Enis Mert Yorulmaz; Serkan Özcan; Osman Köse; Sacit Nuri Görgel; Yiğit Akın

Makale detayları

Optimising Imaging Strategies in Suspected Urolithiasis: Effects on Diagnostic and Therapeutic Timelines

Yazarlar:

Mertcan Dama | Enis Mert Yorulmaz | Serkan Özcan | Osman Köse | Sacit Nuri Görgel | Yiğit Akın

Yayıncı:

Harran University

Ana Başlıklar:

Üroloji

Dergi:

Harran Üniversitesi Tıp Fakültesi Dergisi Vol.22 Issue 3, pp.582-587

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001352421

pISSN:

1304-9623

Anahtar kelimeler:

Özet:

 Background: Prompt imaging is essential in the diagnosis and management of urinary stone disease. While international guidelines recommend ultrasonography US as the first-line modality due to its safety and accessibility, delays in imaging and treatment are common in overcrowded healthcare systems. This study aimed to compare the clinical timelines and outcomes of patients undergoing initial US versus direct non-contrast computed tomography NCCT. Materials and Methods: This retrospective study included 120 adult patients who presented to the urology department of a tertiary care hospital in Türkiye with suspected urinary stone disease. Patients were categorised based on their initial imaging modality. Time intervals from admission to imaging and from admission to definitive treatment were recorded. Treatment rates and return visits were also evaluated. Logistic regression and receiver operating characteristic ROC analyses were performed to identify predictors of treatment. Results: The median time to initial imaging and to definitive treatment was significantly shorter in patients who underwent direct NCCT compared to those who underwent initial US 4 vs. 10 days and 15 vs. 33.5 days, respectively; p  0.001 for both. Multivariate analysis showed that longer imaging delays were independently associated with reduced odds of receiving treatment OR: 0.859; 95 CI: 0.7700.958; p  0.006. ROC analysis demonstrated moderate predictive performance AUC  0.658. Conclusions: In resource-limited, high-volume settings, US may lead to diagnostic and therapeutic delays despite guideline recommendations. Direct low-dose NCCT may offer a more efficient alterna-tive without significantly increasing radiation exposure or cost. Imaging strategies should be tailored to local healthcare realities to ensure timely management of stone disease.

 Background: Prompt imaging is essential in the diagnosis and management of urinary stone disease. While international guidelines recommend ultrasonography US as the first-line modality due to its safety and accessibility, delays in imaging and treatment are common in overcrowded healthcare systems. This study aimed to compare the clinical timelines and outcomes of patients undergoing initial US versus direct non-contrast computed tomography NCCT. Materials and Methods: This retrospective study included 120 adult patients who presented to the urology department of a tertiary care hospital in Türkiye with suspected urinary stone disease. Patients were categorised based on their initial imaging modality. Time intervals from admission to imaging and from admission to definitive treatment were recorded. Treatment rates and return visits were also evaluated. Logistic regression and receiver operating characteristic ROC analyses were performed to identify predictors of treatment. Results: The median time to initial imaging and to definitive treatment was significantly shorter in patients who underwent direct NCCT compared to those who underwent initial US 4 vs. 10 days and 15 vs. 33.5 days, respectively; p  0.001 for both. Multivariate analysis showed that longer imaging delays were independently associated with reduced odds of receiving treatment OR: 0.859; 95 CI: 0.7700.958; p  0.006. ROC analysis demonstrated moderate predictive performance AUC  0.658. Conclusions: In resource-limited, high-volume settings, US may lead to diagnostic and therapeutic delays despite guideline recommendations. Direct low-dose NCCT may offer a more efficient alterna-tive without significantly increasing radiation exposure or cost. Imaging strategies should be tailored to local healthcare realities to ensure timely management of stone disease.

 Background: Prompt imaging is essential in the diagnosis and management of urinary stone disease. While international guidelines recommend ultrasonography US as the first-line modality due to its safety and accessibility, delays in imaging and treatment are common in overcrowded healthcare systems. This study aimed to compare the clinical timelines and outcomes of patients undergoing initial US versus direct non-contrast computed tomography NCCT. Materials and Methods: This retrospective study included 120 adult patients who presented to the urology department of a tertiary care hospital in Türkiye with suspected urinary stone disease. Patients were categorised based on their initial imaging modality. Time intervals from admission to imaging and from admission to definitive treatment were recorded. Treatment rates and return visits were also evaluated. Logistic regression and receiver operating characteristic ROC analyses were performed to identify predictors of treatment. Results: The median time to initial imaging and to definitive treatment was significantly shorter in patients who underwent direct NCCT compared to those who underwent initial US 4 vs. 10 days and 15 vs. 33.5 days, respectively; p  0.001 for both. Multivariate analysis showed that longer imaging delays were independently associated with reduced odds of receiving treatment OR: 0.859; 95 CI: 0.7700.958; p  0.006. ROC analysis demonstrated moderate predictive performance AUC  0.658. Conclusions: In resource-limited, high-volume settings, US may lead to diagnostic and therapeutic delays despite guideline recommendations. Direct low-dose NCCT may offer a more efficient alterna-tive without significantly increasing radiation exposure or cost. Imaging strategies should be tailored to local healthcare realities to ensure timely management of stone disease.

 Amaç: Üriner sistem taş hastalığının tanı ve tedavisinde hızlı görüntüleme büyük önem taşımaktadır. Uluslararası kılavuzlar, güvenliği ve erişilebilirliği nedeniyle ilk basamak görüntüleme yöntemi olarak ultrasonografiyi USG önermektedir. Ancak, özellikle yoğun sağlık sistemlerinde görüntüleme ve tedavi süreçlerinde gecikmeler sıkça yaşanmaktadır. Bu çalışmanın amacı, ilk görüntüleme yöntemi olarak USG ile doğrudan kontrastsız bilgisayarlı tomografi NCCT uygulanan hastaların klinik zaman çizelgelerini ve sonuçlarını karşılaştırmaktır. Materyal ve Metod: Bu retrospektif çalışmaya, Türkiyede bir üçüncü basamak hastanenin üroloji bölümüne üriner sistem taşı şüphesiyle başvuran 120 erişkin hasta dahil edildi. Hastalar, ilk uygulanan görüntüleme yöntemine göre gruplandırıldı. Başvuru ile görüntüleme ve kesin tedavi arasındaki süreler kaydedildi. Tedavi oranları ve tekrar başvuru sıklıkları değerlendirildi. Tedaviyi öngören değişkenleri belirlemek amacıyla lojistik regresyon ve ROC analizleri uygulandı. Bulgular: İlk görüntüleme olarak doğrudan NCCT uygulanan hastalarda, USG yapılanlara kıyasla görüntü-leme ve kesin tedaviye ulaşma sürelerinin anlamlı derecede daha kısa olduğu belirlendi sırasıyla 4 vs. 10 gün ve 15 vs. 33.5 gün; her ikisi için p  0.001. Çok değişkenli analizde, görüntülemede yaşanan gecikmelerin tedavi alma olasılığını bağımsız olarak azalttığı görüldü OR: 0.859; 95 GA: 0.7700.958; p  0.006. ROC analizi, orta düzeyde öngörü performansı gösterdi AUC  0.658. Sonuç: Kaynakların sınırlı olduğu ve hasta yoğunluğunun yüksek olduğu sağlık sistemlerinde, kılavuzlara rağmen USG tanı ve tedavide gecikmelere yol açabilir. Düşük doz NCCT, radyasyon maruziyetini veya maliyeti önemli ölçüde artırmadan daha verimli bir alternatif sunabilir. Taş hastalığının zamanında yönetimi için görüntüleme stratejileri yerel sağlık sistemi koşullarına göre uyarlanmalıdır.

Makale detayları

Optimising Imaging Strategies in Suspected Urolithiasis: Effects on Diagnostic and Therapeutic Timelines

Yazarlar:

Mertcan Dama | Enis Mert Yorulmaz | Serkan Özcan | Osman Köse | Sacit Nuri Görgel | Yiğit Akın

Yayıncı:

Harran University

Ana Başlıklar:

Üroloji

Dergi:

Harran Üniversitesi Tıp Fakültesi Dergisi Vol.22 Issue 3, pp.582-587

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001352421

pISSN:

1304-9623

Computed Tomography

Diagnostic Imaging

Ultrasonography

UrolithiasisBilgisayarlı Tomografi

Ultrasonografi

Ürolitiazis

Tanısal Görüntüleme

Sayı

Makale detayları

Yazarlar: Mertcan Dama | Enis Mert Yorulmaz | Serkan Özcan | Osman Köse | Sacit Nuri Görgel | Yiğit Akın

Yayıncı: Harran University

Ana Başlıklar: Üroloji

Dergi: Harran Üniversitesi Tıp Fakültesi Dergisi Vol.22 Issue 3, pp.582-587

Belge Tipi: Makale

Yayın Tarihi: 9/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001352421

pISSN: 1304-9623

Sayı

Yazarlar:

Mertcan Dama | Enis Mert Yorulmaz | Serkan Özcan | Osman Köse | Sacit Nuri Görgel | Yiğit Akın

Yayıncı:

Harran University

Ana Başlıklar:

Üroloji

Dergi:

Harran Üniversitesi Tıp Fakültesi Dergisi Vol.22 Issue 3, pp.582-587

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001352421

pISSN:

1304-9623