Computed tomography window affects kidney stones measurements

Danilovic, Alexandre; Rocha, Bruno Aragão; Marchini, Giovanni Scala; Traxer, Olivier; Batagello, Carlos; Vicentini, Fábio Carvalho; Torricelli, Fábio César Miranda; Srougi, Miguel; Nahas, William Carlos; Mazzucchi, Eduardo

doi:10.1590/s1677-5538.ibju.2018.0819

Cited by 21 publications

(15 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Finally, special attention must be paid to the NECT protocol, which has been shown to influence outcomes. Insufficient slice thickness (3–5 mm) and low-dose irradiation protocols may alter the detection or precision of the segmented volume, especially in obese patients, as well as the calibration window [ 21 , 22 ]. In the present work, the window was manually adjusted, and the NECT panel included various settings, but changes in these settings did not alter the correlation between operators.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of a free 3D software for kidney stones’ surgical planning: “kidney stone calculator” a pilot study

et al. 2021

Self Cite

View full text Add to dashboard Cite

Introduction Kidney Stone Calculator (KSC) is a free, three-dimensional (3D) planning software for flexible ureteroscopy(fURS) with Holmium:YAG(Ho:YAG) endocorporeal lithotripsy (EL). KSC provides the stone volume (SV) and expected duration of lithotripsy (ExDL) estimations based on non-enhanced-CT scan (NECT) DICOM series. We aimed to provide a preclinical and clinical evaluation of KSC. Patients and methods A preclinical evaluation measured the SV by three operators (resident, endourology expert and research engineer) among 17 NECT cases. Between January and March 2020, a multicentric, prospective, observational double-blind clinical evaluation was conducted in patients presenting with renal stones treated with Ho:YAG-EL during fURS and preoperative NECT. Demographic and surgical data were collected. The primary endpoint was a significant median difference between ExDL and EffectiveDL (EfDL). Second, efficiency (J/mm 3 ) and efficacy (mm 3 /min) ratios were calculated. Results The preclinical evaluation showed no significant difference in the SV measurements among operators ( p > 0.05). Pearson and Kendall coefficients of 0.99 and 0.98, respectively, were found. Twenty-six patients were included in the clinical evaluation, with a median age of 55 years. In 66% of cases, there was a single stone located in the lower pole, with a density > 1000 Hounsfield Unit observed in 42% and 85% of cases. A 14% [Q1–Q3 (5.4–24.8); p = 0.36] median difference between ExDL and EfDL was noted, which was greater in the case of lower pole stones with no possible relocation ( p = 0.008). Median values of 17.6 J/mm 3 and 0.4 (0.32–0.56) mm 3 /s EL were also noted. Conclusions Kidney Stone Calculator is a reproducible and accurate software that allows for an estimation of the stone burden and provides an ExDL for URSf. Defining the influencing factors of EL will improve its ExDL. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-021-03671-z.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In the present work, the window was manually adjusted, and the NECT panel included various settings, but changes in these settings did not alter the correlation between operators. Further improvements in KSC would include automatic detection using deep learning, as used for kidney segmentation [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a free 3D software for kidney stones’ surgical planning: “kidney stone calculator” a pilot study

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Stone size sum was considered the sum of the longest diameter of each stone in the renal unit. Stone volume sum was calculated using the sum of the volume of each stone in the renal unit using ellipsoid formula as 0.167x π x length x width x depth (21,22) Stone density was measured by free hand region of interest (ROI) determination coincident with the stone borders (23). Infundibulopelvic angle of the inferior calyx was measured in all patients using the method previously reported (24).…”

Section: Methodsmentioning

confidence: 99%

Does previous standard percutaneous nephrolithotomy impair retrograde intrarenal surgery outcomes?

et al. 2021

Self Cite

View full text Add to dashboard Cite

Purpose: The objective of this study is to evaluate the impact of a previous standard percutaneous nephrolithotomy (PCNL) on the outcomes of retrograde intrarenal surgery (RIRS). Materials and Methods: Outcomes of RIRS performed from January 2017 to January 2020 in adult patients with residual stone fragments ≤20mm after a standard PCNL (Post-PCNL) and symptomatic adult patients with kidney stones ≤20mm (Control) were prospectively studied. Stone-free rate (SFR) was evaluated on a postoperative day 90 non-contrast computed tomography. Surgical complications based on Clavien-Dindo classification during the 90 days of follow-up were recorded. Results: Outcomes of 55 patients and 57 renal units of the post-PCNL group were compared to 92 patients and 115 renal units of the control group. SFR was lower in post-PCNL group than in control (28/57, 49.1% vs. 86/115, 74.8%, p <0.001). Overall complications were more frequent in post-PCNL group (p=0.004). Infundibula strictures were identified and incised with laser in 15/57 (26.3%) renal units of the post-PCNL group. Thirteen renal units had infundibulum stricture at the site of previous percutaneous tract (13/15; 86.7%, p=0.004) and one renal unit had three infundibula strictures. Postoperative complications were not affected by the treatment of infundibula strictures (p=0.198). Conclusions: Previous standard PCNL significantly impairs the outcomes of RIRS. Infundibula strictures can be found in 26.3% of the patients with residual stone fragments after standard PCNL for large burden kidney stones. The main site of infundibulum stricture after standard PCNL is the infundibulum of the entry ca lyx .

show abstract

“…Stone density was measured by free hand region of interest determination coincident with the stone borders. 13 Infundibulopelvic angle of the inferior calix was measured as previously reported. 14 Standardized RIRS was performed under general anesthesia at least 6 weeks after PCNL.…”

Section: Methodsmentioning

confidence: 99%

Residual Stone Fragments After Percutaneous Nephrolithotomy: Shockwave Lithotripsy vs Retrograde Intrarenal Surgery

Danilovic

Torricelli

Marchini

et al. 2021

Journal of Endourology

Self Cite

View full text Add to dashboard Cite

Background: Despite technology incorporation to percutaneous nephrolithotomy (PCNL), residual stone fragments (RSFs) may still persist after PCNL and need to be addressed to avoid regrowth or ureteral obstruction. The objective of this study was to compare the outcomes of retrograde intrarenal surgery (RIRS) to extracorporeal shockwave lithotripsy (SWL) for treating patients with RSFs after a previous standard PCNL. Materials and Methods: Adult patients with RSF after a standard PCNL submitted to RIRS or SWL in our Institution from January 2017 to January 2020 were retrospectively studied. Stone-free rate (SFR) was evaluated on postoperative day (POD) 90 by noncontrast CT (NCCT) or ultrasound and kidney, ureter, and bladder radiograph (KUB) for each renal unit. Surgical complications based on Clavien-Dindo classification during the 90 days of follow-up were recorded. Sample size was calculated for a power of 80% and a significance level of 0.05, assuming SFR of 20% for SWL and 50% for RIRS. Results: Thirty-three patients treated by SWL were compared with 36 patients treated by RIRS. Hospitalization time was longer in the RIRS group (4.18 vs 12.33 hours, p = 0.001). SFR and success rate were lower in SWL than RIRS group (24.2% vs 58.3%, p = 0.007 and 30.3% vs 72.2%, p = 0.004, respectively), using POD 90 NCCT in 81.8% and ultrasound and KUB in 18.2% of the SWL group and using POD 90 NCCT in 100% of the RIRS group. Minor complications (Clavien-Dindo < III) occurred in 11 of 36 (30.6%) patients submitted to RIRS and in 2 of 33 (6.1%) patients submitted to SWL group ( p = 0.025). Two patients (6.1%) of the SWL group had Clavien-Dindo IIIb complication owing to Steinstrasse and were submitted to ureteroscopy. Emergency room visits were similar between groups (6.1% vs 8.3%, p = 1.0). Conclusions: RIRS has better SFR, higher minor complications, and lower major complications than SWL for the treatment of RSFs after standard PCNL.

show abstract

Computed tomography window affects kidney stones measurements

Cited by 21 publications

References 32 publications

Evaluation of a free 3D software for kidney stones’ surgical planning: “kidney stone calculator” a pilot study

Evaluation of a free 3D software for kidney stones’ surgical planning: “kidney stone calculator” a pilot study

Does previous standard percutaneous nephrolithotomy impair retrograde intrarenal surgery outcomes?

Residual Stone Fragments After Percutaneous Nephrolithotomy: Shockwave Lithotripsy vs Retrograde Intrarenal Surgery

Contact Info

Product

Resources

About