Kidney Stone Detection on Ultrasound
Purpose | To detect kidney, ureteral, or bladder stones on US |
Tag(s) |
|
Panel | Abdominal |
Define-AI ID | 20020007 |
Originator | Luther B. Adair, II |
Lead | Luther B. Adair, II |
Panel Chair | Arun Krishnaraj |
Panel Reviewers | Abdominal Panel |
License | Creative Commons 4.0 |
Status | Public Comment |
RadElement Set | RDES158 |
Clinical Implementation
Value Proposition
Distinguishing between hydronephrosis due to mass effect on the distal ureter in pregnancy versus urolithiasis as a cause is a common reason renal ultrasound is ordered as an alternative to CT. Additionally, renal ultrasound is often ordered in an outpatient setting to ascertain a cause for abnormal renal function, specifically to exclude hydronephrosis. AI meeting this use case would help in detecting, quantitating, comparing, and alerting both nonspecialists and radiologists to these abnormalities. In clinical settings where a radiologist is not readily available, such detection would be of value to non-radiologists such as technologists who would perform an ultrasound for this disease entity. In clinical settings where radiologists are available, such detection could be used to alert the radiologist and prioritize its reporting and notification to the treating physicians.
Narrative(s)
A 35-year old pregnant patient presents to an emergency room with abdominal pain at which time ultrasound is ordered.
A 65-year old patient presents to an outpatient office with abnormal renal function and abdominal pain and ultrasound is ordered.
Workflow Description
The relevant images are obtained from the modality and sent to PACS and the AI engine based on anatomic landmarks. The images are analyzed by the engine. The system then detects the relevant outputs providing associated categorical data or measurements. An alert message is sent back to the engine with information, identification, and graphics highlighting the presence of a renal calculus, ureteral calculus, urinary bladder calculus, or hydronephrosis. Calculus on ultrasound is defined as a hyperechoic focus with posterior shadowing or “twinkle” artifact.
An algorithm evaluates the ultrasound images and assesses whether a renal calculus(s) is present, absent, or undetermined. If present, it then counts the number of calculi in each kidney and measures the largest on each side. It will also assess whether a ureteral calculus is present, absent, or indeterminate. If present, it then measures the calculus. Assesses whether a bladder calculus is present, absent, or undetermined. If present, it then measures the calculus.Assesses whether hydronephrosis is see comment below regarding laterality and quantifying degree of hydronephrosis. For cases where the algorithm returns any degree of hydronephrosis is present, the exam is prioritized in the radiologist’s worklist for urgent interpretation and reporting.
Considerations for Dataset Development
Procedures | {retroperitoneal ultrasound, renal ultrasound, renal ultrasound limited} |
View(s) | {transverse, longitudinal} |
Age | [0,90] |
Sex at Birth | {Male, Female} |
Abdominal pain | {left flank pain, right flank pain, abdominal pain} |
Other | {hydronephrosis} |
Confounding variables | {percutaneous nephrostomy, ureteral catheter, vascular calculus [calcified atherosclerosis in renal arteries], echogenic renal sinus fat, emphysematous pyelonephritis or cystitis, air within the collecting system, Foley catheter} |
Technical Specifications
Inputs
DICOM Study
Procedure | Renal ultrasound |
Views | Transverse, longitudinal |
Data Type | DICOM |
Modality | ultrasound |
Body Region | Abdomen and pelvis |
Anatomic Focus | Kidneys, ureters, urinary bladder |
Primary Outputs
Renal Calculus Detection
RadElement ID | |
Definition | Detection of renal calculus |
Data Type | Categorical |
Value Set |
|
Units | N/A |
Number of Renal Calculus
RadElement ID | |
Definition | If renal calculus present, note the number of calculi |
Data Type | Numeric |
Value Set | N/A |
Units | N/A |
Renal Calculus Kidney Laterality
RadElement ID | |
Definition | If renal calculus present, note which kidney involved |
Data Type | Categorical |
Value Set |
|
Units | N/A |
Renal Calculus Measurement
RadElement ID | |
Definition | Measurement of renal calculus |
Data Type | Numeric |
Value Set | N/A |
Units | millimeters |
Ureteral Calculus Detection
RadElement ID | |
Definition | Detection of ureteral calculus |
Data Type | Categorical |
Value Set |
|
Units | N/A |
Ureteral Calculus Kidney Laterality
RadElement ID | |
Definition | If ureteral calculus present, specify which kidney involved |
Data Type | Categorical |
Value Set |
|
Units | N/A |
Ureteral Calculus Measurement
RadElement ID | |
Definition | Measurement of ureteral calculus |
Data Type | Numeric |
Value Set | N/A |
Units | millimeters |
Bladder Calculus Detection
RadElement ID | |
Definition | Detection of bladder calculus |
Data Type | Categorical |
Value Set |
|
Units | N/A |
Bladder Calculus Measurement
RadElement ID | |
Definition | Measurement of bladder calculus |
Data Type | Numeric |
Value Set | N/A |
Units | millimeters |
Secondary Outputs
Hydronephrosis Detection
RadElement ID | |
Definition | Detection of hydronephrosis |
Data Type | Categorical |
Value Set |
|
Units | N/A |
Hydronephrosis Kidney Laterality
RadElement ID | |
Definition | If Hydronephrosis present, note which kidney involved |
Data Type | Categorical |
Value Set |
|
Units | N/A |
Future Development Ideas
-
Possible extension to this use case is to detect nephrolithiasis and hydronephrosis on ultrasound and assess the need for further imaging based on the absence or presence of hydronephrosis.
Related Datasets
No known related public datasets at this time, please alert us if you know of any.