Barbrina Dunmire1, Jonathan D Harper2, Bryan W Cunitz3, Franklin C Lee2, Ryan Hsi2, Ziyue Liu4, Michael R Bailey5, Mathew D Sorensen6. 1. Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington. Electronic address: mrbean@uw.edu. 2. Department of Urology, University of Washington School of Medicine, Seattle, Washington. 3. Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington. 4. Department of Biostatistics, Indiana University Schools of Medicine and Public Health, Indianapolis, Indiana. 5. Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington; Department of Urology, University of Washington School of Medicine, Seattle, Washington. 6. Department of Urology, University of Washington School of Medicine, Seattle, Washington; Division of Urology, Department of Veteran Affairs Medical Center, Seattle, Washington.
Abstract
PURPOSE: Ultrasound is known to overestimate kidney stone size. We explored measuring the acoustic shadow behind kidney stones combined with different ultrasound imaging modalities to improve stone sizing accuracy. MATERIALS AND METHODS: A total of 45 calcium oxalate monohydrate stones were imaged in vitro at 3 different depths with the 3 different ultrasound imaging modalities of conventional ray line, spatial compound and harmonic imaging. The width of the stone and the width of the acoustic shadow were measured by 4 operators blinded to the true size of the stone. RESULTS: Average error between the measured and true stone width was 1.4 ± 0.8 mm, 1.7 ± 0.9 mm, 0.9 ± 0.8 mm for ray line, spatial compound and harmonic imaging, respectively. Average error between the shadow width and true stone width was 0.2 ± 0.7 mm, 0.4 ± 0.7 mm and 0.0 ± 0.8 mm for ray line, spatial compound and harmonic imaging, respectively. Sizing error based on the stone width worsened with greater depth (p <0.001) while the sizing error based on the shadow width was independent of depth. CONCLUSIONS: Shadow width was a more accurate measure of true stone size than a direct measurement of the stone in the ultrasound image (p <0.0001). The ultrasound imaging modality also impacted the measurement accuracy. All methods performed similarly for shadow size while harmonic imaging was the most accurate stone size modality. Overall 78% of the shadow sizes were accurate to within 1 mm, which is similar to the resolution obtained with clinical computerized tomography.
PURPOSE: Ultrasound is known to overestimate kidney stone size. We explored measuring the acoustic shadow behind kidney stones combined with different ultrasound imaging modalities to improve stone sizing accuracy. MATERIALS AND METHODS: A total of 45 calcium oxalate monohydrate stones were imaged in vitro at 3 different depths with the 3 different ultrasound imaging modalities of conventional ray line, spatial compound and harmonic imaging. The width of the stone and the width of the acoustic shadow were measured by 4 operators blinded to the true size of the stone. RESULTS: Average error between the measured and true stone width was 1.4 ± 0.8 mm, 1.7 ± 0.9 mm, 0.9 ± 0.8 mm for ray line, spatial compound and harmonic imaging, respectively. Average error between the shadow width and true stone width was 0.2 ± 0.7 mm, 0.4 ± 0.7 mm and 0.0 ± 0.8 mm for ray line, spatial compound and harmonic imaging, respectively. Sizing error based on the stone width worsened with greater depth (p <0.001) while the sizing error based on the shadow width was independent of depth. CONCLUSIONS: Shadow width was a more accurate measure of true stone size than a direct measurement of the stone in the ultrasound image (p <0.0001). The ultrasound imaging modality also impacted the measurement accuracy. All methods performed similarly for shadow size while harmonic imaging was the most accurate stone size modality. Overall 78% of the shadow sizes were accurate to within 1 mm, which is similar to the resolution obtained with clinical computerized tomography.
Authors: Barbrina Dunmire; Franklin C Lee; Ryan S Hsi; Bryan W Cunitz; Marla Paun; Michael R Bailey; Mathew D Sorensen; Jonathan D Harper Journal: J Endourol Date: 2014-09-17 Impact factor: 2.942
Authors: Rebecca Smith-Bindman; Chandra Aubin; John Bailitz; Rimon N Bengiamin; Carlos A Camargo; Jill Corbo; Anthony J Dean; Ruth B Goldstein; Richard T Griffey; Gregory D Jay; Tarina L Kang; Dana R Kriesel; O John Ma; Michael Mallin; William Manson; Joy Melnikow; Diana L Miglioretti; Sara K Miller; Lisa D Mills; James R Miner; Michelle Moghadassi; Vicki E Noble; Gregory M Press; Marshall L Stoller; Victoria E Valencia; Jessica Wang; Ralph C Wang; Steven R Cummings Journal: N Engl J Med Date: 2014-09-18 Impact factor: 91.245
Authors: Philip C May; Yasser Haider; Barbrina Dunmire; Bryan W Cunitz; Jeff Thiel; Ziyue Liu; Matthew Bruce; Michael R Bailey; Mathew D Sorensen; Jonathan D Harper Journal: J Endourol Date: 2016-09 Impact factor: 2.942
Authors: Jessica C Dai; Barbrina Dunmire; Ziyue Liu; Kevan M Sternberg; Michael R Bailey; Jonathan D Harper; Mathew D Sorensen Journal: J Endourol Date: 2018-10-22 Impact factor: 2.942
Authors: Jessica C Dai; Barbrina Dunmire; Kevan M Sternberg; Ziyue Liu; Troy Larson; Jeff Thiel; Helena C Chang; Jonathan D Harper; Michael R Bailey; Mathew D Sorensen Journal: World J Urol Date: 2017-12-14 Impact factor: 4.226
Authors: C Seitz; T Bach; M Bader; W Berg; T Knoll; A Neisius; C Netsch; M Nothacker; S Schmidt; M Schönthaler; R Siener; R Stein; M Straub; W Strohmaier; C Türk; B Volkmer Journal: Urologe A Date: 2019-11 Impact factor: 0.639