Determination of Renal Stone Composition with Dual-Energy CT: In Vivo Analysis and Comparison with X-ray Diffraction

Hidas, Guy; Eliahou, Ruth; Duvdevani, Mordechai; Coulon, Phillipe; Lemaître, L.; Gofrit, Ofer N.; Pode, Dov; Sosna, Jacob

doi:10.1148/radiol.10100249

Cited by 210 publications

(117 citation statements)

References 21 publications

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“…[10] Hardness of the renal stones can be assessed by non-contrast computed tomography (NCCT). [11][12][13] In the current study, we have investigated the impact of stone Hounsfield Units (HU) on the surgical outcomes of FURS in the treatment of large renal pelvic stones measuring 2-3 cm in size.…”

Section: Introductionmentioning

confidence: 99%

Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"

Hamed

Elmoghazy

Mohamed

et al. 2017

Turkish Journal of Urology

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Objective: To evaluate the stone hardness in predicting the need for single or two sessions of retrograde intrarenal surgery (RIRS) for renal pelvis stones of 2-3 cm in size. Material and methods:Ninety-six patients (64 male and 32 female) with only renal stones (2.5±0.3 cm) underwent RIRS using flexible 7.5 Fr ureteroscope (FURS). The stone hardness was evaluated by preoperative non-contrast computed tomography (NCCT). The patients were divided into two groups based on stone hardness: Group I (n=54) (hard stones -Hounsfield Unit (HU) >1000) and group II (n=42) (not hard stone -HU <1000). The stone-free rate, the operative time, any intra or postoperative complications and the need for second sessions of RIRS were evaluated.Results: All stones were successfully accessed. Intraoperative complications were not reported. The initial stone-free rate was 40% in Group I and 95% in Group II after a single session (p= 0.01). A second session FURS was needed in 32 cases of Group I (40%) where postoperative CT showed significant residual stone fragments of 6±2 mm, and stone-free rate up to 100 percent. On the contrary only 2 cases from Group II underwent second session FURS (p= 0.01). The operative times were 75±15 minutes in Group I and 55±13 minutes in Group II (p<0.01). Six patients (4 in group I and 2 in group II) had postoperative high-grade fever (Clavien Grade II). Conclusion:Stone hardness had a significant impact on the decision of performing single versus two sessions of FURS for renal pelvic stones of 2-3 cm rather than the stone size alone.

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Section: Introductionmentioning

confidence: 99%

Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"

Hamed

Elmoghazy

Mohamed

et al. 2017

Turkish Journal of Urology

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“…Moreover, with the need to evaluate the nephrogram and ureterogram phases, and calculus opacities, each additional dynamic CT scan increases the dose and these exams require contrast administration. [20] Although rare, the contrast medium itself may cause serious acute (anaphylactic reaction) or late-onset (nephropathy) side effects. [21,22] Conspicuous uncomplicated or asymptomatic urinary pathologies, such as mild dilation or mild stasis due to conditions such as a peripelvic cyst, persistent caliectasis, or prominent extrarenal pelvis, should be able to be evaluated using methods other than those involving contrast enhancement or radiation exposure, especially in young patients who are the most sensitive to the hazards of radiation or anaphylaxis.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of ureteric jet flow with Doppler ultrasonography during manual compression

Yıldırım¹,

Bozkurt²,

Çırakoğlu³

2011

Turkish Journal of Urology

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Objective: This study aimed to distinguish between obstructive and non-obstructive dilation of the upper urinary tract using ureterovesical jet flow analysis with Doppler ultrasonography (US) and manual flank compression. Materials and methods:The study enrolled 54 patients (11 women, 43 men; mean age 27.5 years) with unilateral hydronephrosis. All but 2 pregnant patients underwent the Doppler US and the reference standard test [intravenous pyelogram (IVP)] after standardized hydration. The distended urinary bladder was visualized in the transverse plane to evaluate both ureteral orifices simultaneously. During and after compression of each flank, the jet flows were recorded in Doppler mode. The jet flows were quantified by calculating the longitudinal extent of the color spread into the bladder on both sides. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the test for determining the degree of obstruction were evaluated statistically. Results:Ureterovesical jet flow could not be visualized with flank compression in 4 cases. Three of these cases had complete obstruction on IVP. In the 22 cases that had markedly reduced flow compared to the contralateral side on Doppler US, the IVP showed similar stasis. In the 19 cases that had mildly diminished flow compared to the contralateral side on Doppler US, no significant difference was detected in the pyelogram and nephrogram phases on IVP.Conclusion: Doppler examination of the ureterovesical jet flows during flank compression may be a good diagnostic method for evaluating the degree of obstruction, especially in patients in whom magnetic resonance imaging or computerized tomography is contraindicated. Gereç ve yöntem:Çalışmaya tek taraflı hidronefroz tespit edilmiş 54 olgu (11 kadın, 43 erkek; ortalama yaş 27.5 yıl) dahil edildi. Hidrasyon düzeyi standardize edilerek, tüm hastalara Doppler US inceleme ve 2 gebe olgu dışındaki diğer tüm hastalara referans standart test olarak intravenöz piyelografi (İVP) yapıldı. Her iki üreter orifisi görülecek şekilde distandü mesane yatay pozisyonda görüntülendi. Renal lojun kompresyonu sırasında ve sonrasında oluşan jet akımlar Doppler mod ile kaydedildi. Mesane içerisine doğru gelişen renk saçılımının uzunluğu dikkate alınarak jet akımlar kantifiye edildi. Obstrüksiyon derecesinin ayırımında sensisitivite, spesifite, pozitif ve negatif prediktif değerler istatistiksel olarak hesaplandı. Bulgular: Üreterovezikal bileşke akımı toplam 4 olguda hiç gözlenemedi. Bunlardan biri hariç diğer üçün-de İVP ile de tam obstrüksiyon rapor edilmişti. Kalan olguların 22'sinde, Doppler US'de karşı tarafa göre kısalmış jetler sözkonusu iken, İVP'de de bununla uyumlu nonprogresif staz görüldü. Diğer 19 olguda, Doppler US'de karşı tarafa göre hafif azalmış jetler sözkonusu iken İVP incelemelerinde piyelogram ve nefrogram fazlarında anlamlı fark tespit edilmemişti. Sonuç:Özellikle manyetik rezonans görüntüleme veya bilgisayarlı tomografinin kontrendike olduğu olgularda, renal lojların manu...

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“…[43] The commonly used stone analysis techniques include in vitro x-ray diffraction, infrared spectroscopy and polarization microscopy. [44] These tests, unfortunately, are performed only after the stones are extracted from the patients. In renal stone preoperative evaluation, minimally invasive intervention is preferred for the benefits of the patients.…”

Section: Renal Stone Datasetmentioning

confidence: 99%

Augmenting cost-SVM with gaussian mixture models for imbalanced classification

He¹,

Silva³

et al. 2015

AIR

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The Support Vector Machine (SVM), a known discriminative classifier is ineffective in dealing with imbalanced classification problems where the training examples of target class are outnumbered by non-target class examples. Though cost-SVM (cSVM) has been proposed to tackle the imbalanced datasets by assigning different cost functions to different classes, the performance is less than satisfactory due to its limited ability to enforce cost-sensitivity. In this research, a generative classifier, Gaussian Mixture Model (GMM) is studied which can learn the distribution of the imbalanced data to improve the discriminative power between imbalanced classes. By fusing this knowledge into cSVM, a model fusion approach, termed CSG (cSVM+GMM), is proposed to tackle the imbalanced classification problem. Experimental results on eleven benchmark datasets and one medical imaging dataset show the effectiveness of CSG in dealing with imbalanced classification problems.

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Determination of Renal Stone Composition with Dual-Energy CT: In Vivo Analysis and Comparison with X-ray Diffraction

Abstract: Dual-energy multidetector CT may enable accurate in vivo characterization of kidney stone composition.

Cited by 210 publications

References 21 publications

Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"

Single session vs two sessions of flexible ureterosopy (FURS) for dusting of renal pelvic stones 2-3 cm in diameter: Does stone size or hardness play a role in number of sessions to be applied?"

Evaluation of ureteric jet flow with Doppler ultrasonography during manual compression

Augmenting cost-SVM with gaussian mixture models for imbalanced classification

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