Methodology of peri-operative imaging data reporting for stone disease: a systematic review toward the development of a novel checklist-iSTAR.

PURPOSE: To critically analyze the methodology of imaging data reporting, including timing, modality and stone burden measurement perioperatively, from recently published literature on surgical interventions for stones, and to develop a scoring system to evaluate its quality.

METHODS

Articles reporting treatment outcomes in adult patients, published in 2020-2021 by preselected journals, were searched on PubMed and Embase. Recorded data for statistical analysis included type of study and intervention, pre- and postoperative imaging modality and timing, stone burden assessment method and measurement, stone free and treatment success definition or their differentiation. A new 7-point checklist (iSTAR-Imaging for Stone Treatment Assessment Reporting) was developed.

RESULTS

A total of 122 studies were included. Several papers did not report on pre- or postoperative imaging modality (13.9% and 5.7%), nor provided a definition of stone burden measurement or treatment success (43% and 18%). Stone burden was most often assessed with Non-Contrast Computed Tomography (54.9%) and reported as stone diameter (75.4%). Definitions of treatment success varied widely across literature, ranging from 0 mm to allowing 4 mm residual fragments. Preoperative imaging timing lacked in 95.9% of studies, while postoperative timing distribution was heterogeneously present. iSTAR scores resulted in 0/7 (0.8%), 1/7 (0.8%), 2/7 (1.6%), 3/7 (7.4%), 4/7 (16.4%), 5/7 (32%), 6/7 (38.5%) and 7/7 (10.7%), independently from study design.

CONCLUSION

This research unveils a lack of standardization in reporting of perioperative urolithiasis imaging. iSTAR checklist may help authors to improve data reporting and provide journals and reviewers with a framework to assess imaging methodology quality in submitted manuscripts.