Using the sound waves of an ultrasound to detect a painful kidney stone is just as effective as the X-rays of a CT scan, says a study. (Thinkstock) SummaryFor years, an abdominal CT scan has been the standard method for detecting kidney stones... Related ArticlesCivic hospitals will soon get more MRI, CT scan machinesHands-free ultrasound plus tPA safe for ischemic stroke�No guidelines under PC-PNDT Act to register ultrasound machines for veterinary use�Samsung Electronics launches premium ultrasound system RS80A Using the sound waves of an ultrasound to detect a painful kidney stone is just as effective as the X-rays of a CT scan, and exposes patients to much less harmful radiation, according to a new multi-center study.
"It's actually quite surprising that ultrasound is just as good as CT scanning when you look at patient outcomes," said Dr. Rebecca Smith-Bindman of the University of California, San Francisco, chief author of the report in the New England Journal of Medicine.
Dr. Charles D. Scales, Jr. of Duke University Medical Center in Durham, North Carolina, called it "a really provocative study� adding, �it should make doctors and patients think about what we do" when a kidney stone may be causing a patient's pain.
"It doesn't necessarily say patients should not get a CT scan," said Scales, who was not connected with the research, "but I think the main message is that an ultrasound is the best place to start."
Kidney stones account for nearly a million emergency room visits in the U.S. each year at a cost of nearly a billion dollars. One in 11 Americans say they have had one.
For years, an abdominal CT scan has been the standard method for detecting stones because it makes the stones easier to see than regular X-rays. But other calcium deposits in the body can be mistaken for stones, leading to unnecessary treatment.
"The CT scan has become the standard of care without really any evidence to support it. So it was initially difficult to get funding for this project because people said, 'You can't use ultrasound. That's crazy,'" Smith-Bindman told Reuters Health in an interview.
In the $9 million three-year study, 2,759 adult patients at 15 emergency departments who were suspected of having a kidney stone were randomly assigned to ultrasound performed by an emergency physician or a radiologist, or to a conventional CT scan.
Beyond finding kidney stones themselves, one reason doctors might be reluctant to give up CT scanning for a suspected kidney stone is the fear that ultrasound might miss a serious problems, such as appendicitis or a ballooning blood vessel, that a CT scan can pick up.
"So we came up with a list of bad things we didn't want to miss," said Smith-Bindman. "If ultrasound missed these really important complications, that would be reason not to use it. Lo and behold, the complications were absolutely the same across the groups. They were infrequent - less
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