2016 FATE OF INDERMINATE/SUSPICIOUS LESIONS FOUND INCIDENTALLY ON CTKUB FOR SUSPECTED RENAL COLIC ? OUTCOMES AFTER A MINIMUM FOLLOW-UP OF 15 MONTHS

Abstract

INTRODUCTION AND OBJECTIVES: CT-KUB is the gold standard for the investigation of suspected renal colic. In addition to stone diagnosis additional pathology can be found in 5-20% of CTKUBs. Although most additional findings are minor, sometimes suspicious/indeterminate lesions are found. With increasing incidence of renal colic and stones these incidental but potentially serious lesions will pose a dilemma to surgeons and patients alike.The aim of this study was assess the fate of these indeterminate lesion found CT-KUB. METHODS: A retrospective review of 404 patients having CTKUB’s for suspected acute renal colic was undertaken between May 2010 and April 2011. Data was collected for patient demographics, presence or calculus disease and additional urological or non-urological pathologies and its clinical relevance. The indeterminate/suspicious lesions were followed up and the data was reviewed in September 2012. RESULTS: The mean age was 50 years (Range: 13-91 years), with 165 females (41%). Ureteric stone was found in 58 (14%), with renal stones in 85 (21%), combined ureteric and renal stones in 39 (10%) patients.The minimum follow up for each patient was 15 months. Clinically relevant non-calculus pathologies were found in 107 patients (26%). A total of 54 patients (13.4%) had indeterminate/suspicious lesion, which required either a follow-up or intervention or further imaging. Of these 6 (11%) patients required operative intervention for malignant or serious condition. A further 13 (24%) patients are still under follow-up imaging after one year. This was specially the case in incidental lung nodules where half of them (8/16) were still under follow-up after 15 months. In 35 (65%) patients a benign diagnosis was made after further imaging and or specialist multidisciplinary team meeting. CONCLUSIONS: CTKUBs are vital for stone diagnosis with a pick up rate of 45%.However, it does pick up other important potential malignant lesions which may need monitoring or intervention. In our study, a third of these lesions were either still under follow-up or had intervention after 15 months of being diagnosed.