Prospective comparison of plain abdominal radiography with conventional and digital renal tomography in assessing renal extracorporeal shock wave lithotripsy patients.

Most publications citing the effectiveness of renal extracorporeal shock wave lithotripsy have used plain abdominal radiography to assess residual calculi after treatment. We compared radiologist sensitivity and specificity in the detection of calculi on plain abdominal radiographs versus conventional film-screen and digital renal tomograms in extracorporeal shock wave lithotripsy patients. Of the patients 50 were imaged before and within 24 hours after lithotripsy. Six radiologists evaluated the resultant 300 studies for the presence and location of calculi. The mean sensitivity for digital tomograms was 83% for pre-lithotripsy and post-lithotripsy studies, which was significantly higher than for plain abdominal radiography and conventional tomography after lithotripsy. However, there were significantly more false positive stone diagnoses associated with digital tomogram interpretation. Signal detection analysis verified the over-all superiority of digital tomography for post-extracorporeal shock wave lithotripsy imaging. Calculus detection by conventional and digital tomography is superior to detection by plain abdominal radiography. However, because we did not perform delayed imaging, it is not possible to say what impact digital tomography might have on the management of extracorporeal shock wave lithotripsy patients.

Radiology reporting: attitudes of referring physicians.

Despite the importance of radiology reports in communicating radiologists' interpretations of imaging studies, little appears to be known about the preferences and attitudes of referring physicians regarding the format and content of such reports. The authors surveyed all physicians who referred patients to the radiology department for their opinions of radiology reports. Two hundred fifty-one physicians (42%) responded. The overall quality of the reports was rated an average of 8 on a ten-point scale, with 10 representing the highest quality. Fifty-nine percent said the reports usually were clear, but 40% thought the reports were occasionally confusing. Forty-nine percent noted the reports sometimes did not sufficiently address the clinical questions. Thirty-two percent preferred the summary statement to be at the beginning of the report, while 29% preferred this portion at the end. Forty respondents (16%) thought that it took too much time to receive the reports. This survey can serve as a model for other radiology departments interested in assessing the attitudes of referring physicians toward radiology reports.