Association Between Randall's Plaque Stone Anchors and Renal Papillary Pits

Borofsky, Michael S.; Williams, James C.; Dauw, Casey A.; Cohen, Andrew J.; Evan, Andrew; Coe, Fredric L.; Worcester, Elaine M.; Lingeman, James E.

doi:10.1089/end.2018.0589

Cited by 9 publications

(4 citation statements)

References 24 publications

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“…The systematic description of the papillary abnormalities allowed the demonstration that different groups of abnormalities were related to different lithogenesis mechanisms. Our results confirm statistically the recent findings of Borofsky [ 15 ]. The observation of pits or erosion (induced by stone drop-off) and anchored stones were indeed related to calcium oxalate lithogenesis on RP, whereas intraductal stones and cryptic papillae were related to intraductal crystallization on plugs.…”

Section: Discussionsupporting

confidence: 93%

Classification of the renal papillary abnormalities by flexible ureteroscopy: evaluation of the 2016 version and update

Alméras¹,

Daudon

Estrade

et al. 2020

World J Urol

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Introduction To assess the use of the 2016 proposed classification of the renal papillary abnormalities during flexible ureteroscopy that aims to standardize their description. Patients and methods We performed a prospective monocentric single operator collection of the data using this classification during 88 consecutive flexible ureteroscopies required for renal stones treatment. Outcome measurements and statistical analysis: data of stones analysis (microscopy and infrared spectrophotometry) and of serum and urines biochemical samples have been compared with the results of the classified endoscopic descriptions. Results Mean duration of description was 81.4 s. We reported that 83% of the patients had Randall plaques (RP), as only 4.5% of the patients had no abnormality. Concerning the papillary stones and anchored stones were observed in 30.7% and aspect of intraductal crystallization (Sc) in 15.9%. Erosions were present in 55.7% and extrophic papillae in 8%. Sa1 and Pa2 were significantly correlated to RP, anchored stones (Sa) to papillary erosions and calcium phosphate stones to intraductal crystallization. Hypercalciuria was significantly higher in Sa2 than Sa1 stones. Conclusions The different descriptions in the 2016 classification were confirmed by the results of this study. Papillary abnormalities are consequences of stones development. Their descriptions could also improve the follow-up and the diagnosis of a metabolic lithogenesis. We recommend their systematic description during ureteroscopy. Some improvements are proposed to update this classification.

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Section: Discussionsupporting

confidence: 93%

Classification of the renal papillary abnormalities by flexible ureteroscopy: evaluation of the 2016 version and update

Alméras¹,

Daudon

Estrade

et al. 2020

World J Urol

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“…The observation of "erosions" or "pits" at the tip of the papilla and the presence of anchored COM stones were also frequent (55.7% and 18.2%, respectively) and correlated with the amount of Randall's plaques (Figure 3) [23][24][25]. They resulted from a dietary cause (especially low fluid intake) in most cases [36][37][38][39].…”

Section: Endoscopic Papillary Recognition (Epr)mentioning

confidence: 96%

“…Since Randall's works [11] in the 1930s, it is known that papillary calculi resulted from subepithelial lesions [12][13][14][15][16][17]. The advent quality of images with flexible retrograde ureteroscopy has allowed the in vivo description of papillary abnormalities [18][19][20][21] that can be related to various lithogenesis mechanisms [22][23][24][25][26][27][28]. Since Randall's works [11] in the 1930s, it is known that papillary calculi resulted from subepithelial lesions [12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Papillary Abnormalities and Stone Recognition (EPSR) during Flexible Ureteroscopy: A Comprehensive Review

Alméras¹,

Pradère

Estrade³

2021

JCM

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Introduction: The increasing efficiency of the different lasers and the improved performance of endoscopic devices have led to smaller stone fragments that impact the accuracy of microscopic evaluation (morphological and infrared). Before the stone destruction, the urologist has the opportunity to analyze the stone and the papillary abnormalities endoscopically (endoscopic papillary recognition (EPR) and endoscopic stone recognition (ESR)). Our objective was to evaluate the value for those endoscopic descriptions. Methods: The MEDLINE and EMBASE databases were searched in February 2021 for studies on endoscopic papillary recognition and endoscopic stone recognition. Results: If the ESR provided information concerning the main crystallization process, EPR provided information concerning the origin of the lithogenesis and its severity. Despite many actual limitations, those complementary descriptions could support the preventive care of the stone formers in improving the diagnosis of the lithogenesis mechanism and in identifying high-risk stone formers. Conclusion: Until the development of an Artificial Intelligence recognition, the endourologist has to learn EPSR to minimize the distortion effect of the new lasers on the stone analysis and to improve care efficiency of the stone formers patients.

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“…The other pathway is plaque, which is made up of subepithelial apatite crystals found on the surface of the papilla [11]. Identifying these precursors allows for removal before stone formation and identifying individuals at risk for a recurring kidney stone episode or linked conditions [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Automatic detection of calcium phosphate deposit plugs at the terminal ends of kidney tubules

Fernandez

Korinek

Camp

et al. 2019

Healthcare Technology Letters

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Kidney stones are a common urologic condition with a high amount of recurrence. Recurrence depends on a multitude of factors the incidence of precursors to kidney stones, plugs, and plaques. One method of characterising the stone precursors is endoscopic assessment, though it is manual and time-consuming. Deep learning has become a popular technique for semantic segmentation because of the high accuracy that has been demonstrated. The present Letter examined the efficacy of deep learning to segment the renal papilla, plaque, and plugs. A U-Net model with ResNet-34 encoder was tested; the Letter examined dropout (to avoid overtraining) and two different loss functions (to address the class imbalance problem. The models were then trained in 1666 images and tested on 185 images. The Jaccard-cross-entropy loss function was more effective than the focal loss function. The model with the dropout rate 0.4 was found to be more effective due to its generalisability. The model was largely successful at delineating the papilla. The model was able to correctly detect the plaques and plugs; however, small plaques were challenging. Deep learning was found to be applicable for segmentation of an endoscopic image for the papilla, plaque, and plug, with room for improvement.

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Association Between Randall's Plaque Stone Anchors and Renal Papillary Pits

Cited by 9 publications

References 24 publications

Classification of the renal papillary abnormalities by flexible ureteroscopy: evaluation of the 2016 version and update

Classification of the renal papillary abnormalities by flexible ureteroscopy: evaluation of the 2016 version and update

Endoscopic Papillary Abnormalities and Stone Recognition (EPSR) during Flexible Ureteroscopy: A Comprehensive Review

Automatic detection of calcium phosphate deposit plugs at the terminal ends of kidney tubules

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