A novel method for prediction of stone composition: the average and difference of Hounsfield units and their cut-off values

Çelik, Serdar; Şefik, Ertuğrul; Basmacı, İsmail; Bozkurt, İbrahim Halil; Aydın, Mehmet Erhan; Yonguç, Tarık; Değirmenci, Tansu

doi:10.1007/s11255-018-1929-3

Cited by 12 publications

(9 citation statements)

References 27 publications

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“…HU measurement is routinely performed in clinical practice to define hardness 7 , 8 and composition 9 , 10 of kidney stones, to predict the outcome of stone treatment 11 , 12 and to differentiate malignant from benign renal tumors 13 , 14 . Computerized tomography (CT) attenuation values of bladder and renal pelvis urine have also been used to predict the positivity of urine cultures with high sensitivity and specificity 15 , 16 .…”

Section: Introductionmentioning

confidence: 99%

Hounsfield unit attenuation value can differentiate pyonephrosis from hydronephrosis and predict septic complications in patients with obstructive uropathy

Boeri

Fulgheri

Palmisano

et al. 2020

Sci Rep

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We aimed to assess the role of computerized tomography attenuation values (Hounsfield unit—HU) for differentiating pyonephrosis from hydronephrosis and for predicting postoperative infectious complications in patients with obstructive uropathy. We analysed data from 122 patients who underwent nephrostomy tube or ureteral catheter placement for obstructive uropathy. A radiologist drew the region of interest for quantitative measurement of the HU values in the hydronephrotic region of the affected kidney. Descriptive statistics and logistic regression models tested the predictive value of HU determination in differentiating pyonephrosis from hydronephrosis and in predicting postoperative sepsis. A HU cut-off value of 6.3 could diagnose the presence of pyonephrosis with 71.6% sensitivity and 71.5% specificity (AUC 0.76; 95%CI: 0.66–0.85). At multivariable logistic regression analysis HU ≥ 6.3 (p ≤ 0.001) was independently associated with pyonephrosis. Patients who developed sepsis had higher HU values (p ≤ 0.001) than those without sepsis. A HU cut-off value of 7.3 could diagnose the presence of sepsis with 76.5% sensitivity and 74.3% specificity (AUC 0.79; 95%CI: 0.71–0.90). At multivariable logistic regression analysis, HU ≥ 7.3 (p ≤ 0.001) was independently associated with sepsis, after accounting for clinical and laboratory parameters. Measuring HU values of the fluid of the dilated collecting system may be useful to differentiate pyonephrosis from hydronephrosis and to predict septic complications in patients with obstructive uropathy.

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Section: Introductionmentioning

confidence: 99%

Hounsfield unit attenuation value can differentiate pyonephrosis from hydronephrosis and predict septic complications in patients with obstructive uropathy

Boeri

Fulgheri

Palmisano

et al. 2020

Sci Rep

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“…We might utilize the Hounsfield units of the stones on preoperative CT to predict the stone component. [21] In our study, RANL was performed clamping the renal hilar vessels as WIT as King et al' study. [13] By comparison, the cold ischemia method which needed a large incision wound for inserting a hand port for placing ice slush around the kidney was used by Ghani et al [14] Although there were 4 of 10 patients who had a slightly prolonged WIT of >30 minutes in our series, postoperative 1-month and 1-year creatinine and eGFR levels were comparable to their preoperative renal function in all patients.…”

Section: Discussionmentioning

confidence: 95%

Robot-assisted anatrophic nephrolithotomy for complete staghorn stone

et al. 2022

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To assess the efficacy and safety of robot-assisted anatrophic nephrolithotomy (RANL) as a choice of minimally invasive treatment for patients with complete staghorn stone. In a single-tertiary referral center retrospective study, 10 consecutive patients underwent RANL for complete staghorn stone. After dissection to the renal hilum and clamping of the renal vessels, an incision was made along the Brodel line and exposed the collecting system to extract the stone. Then, the collecting system and parenchyma were closed in layers. The outcomes included reduction of the stone burden, short- and long-term postoperative kidney function, and pain score. The average age of patients was 54.6 years and body mass index was 27.58 kg/m2. Mean warm ischemia time was 28.40 minutes, mean robotic console time was 137 minutes, and mean estimated blood loss was 83 mL. The mean length of stay was 5.4 days and there were no severe perioperative complications. Eight of 10 patients had >90% reduction in stone burden and 5 (50%) patients were completely stone-free. There was no significant decrease in postoperative estimated glomerular filtration rate compared with preoperative values after 1 month and 1 year. Our experience with RANL demonstrated efficacy and safety in the minimally invasive treatment of complete staghorn stone in short- and long-term follow-up periods.

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“…HU, HU density or HU diff can be used for assessment of ureteral stones (10). These parameters have been evaluated in the literature and their success has been proven in many studies with different results.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hounsfield Unit and İntraoperative “GATA Scale” Score to Determine Requirement of DJ Stent Insertion in Ureteral Stone Treatment

Ediz¹,

Akan²,

Şahin³

et al. 2020

jus

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In this study, we aimed to determine the contribution of hounsfield unit (HU) measurement with non-contrast-enhanced computed tomography to the treatment of a single ureteral stone, and compare the value of HU and intraoperative "GATA scale" score in deciding for DJ stent placement in patients with a single ureteral stone. Materials and Methods: Ninety patients diagnosed with a single ureteral stone in our clinic between January 2018 and September 2018 were evaluated prospectively. We planned a new scale called "GATA scale" with three benchmarks. The validity and reliability of HU were compared with those of GATA scale score. Statistical significance was defined as p<0.05. Results: The mean stone volume at diagnosis was 245.29±23.9 mm 3. The mean HU of ureteral stones was 1065.21±33.5. The mean total score according to GATA scale was 6.44±0.2. To determine the threshold value for factors affecting stent placement after lithotripsy, receiver operating characteristic analysis was performed for stone volume, laser duration, total energy to complete laser lithotripsy and GATA scale score and showed that the optimal thresholds were 164.01 mm 3 , 4.25 mins, 1004 W and 7.5, respectively. Conclusion: In clinical practice, GATA scale can be used in decision making for DJ stents placement. Stent placement following lithotripsy is recommended especially in patients with a stone volume of greater than 160 mm 3 or total energy to complete laser lithotripsy over 1000 W or laser duration longer than 4 minutes or GATA scale score higher than 7.

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A novel method for prediction of stone composition: the average and difference of Hounsfield units and their cut-off values

Abstract: HU and HU were significant predictors of mineral complexity. HU of < 341.5 HU showed 81.8% sensitivity and 67.2% specificity for identification of mono-mineral stones.

Cited by 12 publications

References 27 publications

Hounsfield unit attenuation value can differentiate pyonephrosis from hydronephrosis and predict septic complications in patients with obstructive uropathy

Hounsfield unit attenuation value can differentiate pyonephrosis from hydronephrosis and predict septic complications in patients with obstructive uropathy

Robot-assisted anatrophic nephrolithotomy for complete staghorn stone

Comparison of Hounsfield Unit and İntraoperative “GATA Scale” Score to Determine Requirement of DJ Stent Insertion in Ureteral Stone Treatment

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