Diagnostic performance of low-dose CT for the detection of urolithiasis : a meta-analysis

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.