Evaluation of computed tomography findings for success prediction after extracorporeal shock wave lithotripsy for urinary tract stone disease

Çelik, Serdar; Bozkurt, Ozan; Kaya, Fatih; Eğriboyun, Sedat; Demir, Ömer; Seçil, Mustafa; Çelebi, İlhan

doi:10.1007/s11255-014-0857-0

Cited by 29 publications

(33 citation statements)

References 16 publications

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“…In recent studies, some possible and accurate predictors were determined that affect the success of SWL and URSL [8–10]. These predictors were stone diameter, stone volume, HU, HD of ureteral stones and grade of hydronephrosis on NCCT.…”

Section: Discussionmentioning

confidence: 99%

“…However, MET using any drug is not yet recommended for mid and proximal ureteral stones. Many reports indicate that the efficacy of SWL and URSL can be predicted by stone related factors from non‐contrast computed tomography (NCCT) findings, measured as hounsfield units (HU), hounsfield density (HD) and stone volume on NCCT [8–10]. Studies of MET, however, have not assessed the predictive value of findings on NCCT.…”

Section: Introductionmentioning

confidence: 99%

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Computed tomography findings predicting the success of silodosin for medical expulsive therapy of ureteral stones

Çelik¹,

Akdeniz²,

Yildirim³

et al. 2017

The Kaohsiung J of Med Scie

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Aim of the study is to investigate the relationship between non-contrast computed tomography (NCCT) findings and stone expulsion rate with medical expulsive therapy (MET) using silodosin for ureteral stones in male adults. Between January 2014 and June 2015, we retrospectively reviewed the patient charts with uncomplicated ureteral stones on NCCT images, who were treated with silodosin for MET. Stone diameter, volume and hounsfield units (HU) measured by NCCT and treatment findings were noted at the end of treatment. Patients were divided into three groups according to the localization as distal, mid and proximal ureteral stones. NCCT and treatment findings were compared between MET success and failure groups in different localizations. Stone expulsion rate was 81.3% for 134 distal, 45.5% for 22 mid and 27.7% for 47 proximal stones. Stone diameter, volume, and HU were significantly lower for success groups with distal and proximal stones (p < 0.05). In ROC analysis the cut-off values for stone volume and HU were detected as 48.7 mm and 598 HU for success group with proximal stones. Stone expulsion rate was found to be 24 times more (OR = 24; p = 0.001) in patients with <598 HU and 14 times more (OR = 14; p = 0.002) in patients with <48.7 mm proximal stones. Lower stone diameter, volume and HU were significant predictors of success with silodosin for MET for ureteral stones. Patients with <598 HU and/or <48.7 mm proximal stones may be prescribed silodosin for MET.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Computed tomography findings predicting the success of silodosin for medical expulsive therapy of ureteral stones

Çelik¹,

Akdeniz²,

Yildirim³

et al. 2017

The Kaohsiung J of Med Scie

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“…HU measurements have been researched many times to date and an absolute inverse correlation has been found between high HU level and SF rates after SWL, URSL and PNL procedures. (9,10,11,12). Especially for URSL, stone fragmentation during the procedure is the most important factor for laser energy level, laser time and operative time.…”

Section: Discussionmentioning

confidence: 99%

“…NCCT provides stone measurements (size and volume), stone location and stone density [Hounsfield units (HU) measurements]. Absolute HU inversely correlates with the effectiveness of extracorporeal shock wave lithotripsy (SWL) and has also been proposed to affect SF rates after URSL and percutaneous nephrolithotomy (PNL) (9)(10)(11)(12). Stone fragmentation is an important factor for SF status, laser and operative times.…”

Section: Introductionmentioning

confidence: 99%

Effects of Laser Probes and Computed Tomography Findings on Ureterorenoscopic Laser Lithotripsy Success Rate, Laser Time, Laser Energy Level and Operative Time for Distal Ureteral Stones

Çelik¹,

Bozkurt²,

Başara³

et al. 2019

jus

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Amaç: Distal üreter taşlarında, preoperatif kontrastsız bilgisayarlı tomografi (BT) bulgularının ve peroperatif lazer prob seçiminin toplam lazer süresi, enerji düzeyi ve üreterorenoskopi (URS) zamanı üzerine etkisini araştırmayı amaçladık. Objective: To investigate the effect of preoperative non-contrast computed tomography (NCCT) findings and peroperative laser probe selection on total laser time, energy level and ureterorenoscopy (URS) time for distal ureteral stones. Materials and Methods: We prospectively evaluated 72 patients with single distal ureteral stone measuring 5-25 mm in diameter on NCCT, who were treated with ureteroscopic lithotripsy (URSL) between June 2015 and October 2016. The patients were divided into two groups according to probe selection as 365 µm and 550 µm groups. Stone diameters, stone volume and Hounsfield units (HU) measured on NCCT, and URSL findings were noted at the end of the treatment. These findings were compared between the groups. Also the possible predictive value of NCCT findings was evaluated for URSL data. Results: There were 17 patients in the 365 µm and 55 patients in the 550 µm groups. There was no significant difference in URSL success rate and other predictive data between the groups. However, among the peroperative data, laser time, laser energy level and laser energy/time ratio were significantly lower in the 365 µm group compared to the 550 µm group (p<0.05). Correlation analysis indicated that total laser time and URS time were correlated with stone diameter, stone volume, HU values and density (HD). Laser energy level was only correlated with longitudinal stone diameter and HD. Conclusion: Stone diameter, volume and HU values are significant predictors of laser energy level, URS and laser time for distal ureteral stones. Also, use of a thinner probe decreases total laser time, laser energy level and laser energy/time ratio. In addition, thinner laser probe shortens URS time.

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“…In recent studies, HU values were evaluated on NCCT to detect a predictive cut-off value of mean HU for the prediction of treatment success (1,2,3,4). In the studies, HU values and stone analysis were compared for the prediction of stone composition.…”

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The Role of Computed Tomography Findings in Prediction of Stone Composition

Çelik¹,

Altay²,

Bozkurt³

et al. 2017

jus

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We evaluated two 18-year-old patients who presented to our clinic with flank pain. The patients underwent metabolic evaluation and non-contrast computed tomography (NCCT). In 24-hour urine analysis, patient-1 had high oxalate and low citrate levels, while patient-2 had a high homocysteine level. NCCT images revealed a renal stone in the right kidney in both patients. Stone diameters and Hounsfield units (HU) were measured with large magnification in bone window on NCCT images (Figure 1). The difference in HU (HUdiff) was calculated as the difference between maximum and minimum HU for estimated and predicted stone homogeneity/heterogeneity and stone composition. After percutaneous nephrolithotomy, stone analysis found a calcium oxalate (CaOX) stone in patient-1 and a cystine stone in patient-2.In recent studies, HU values were evaluated on NCCT to detect a predictive cut-off value of mean HU for the prediction of treatment success (1,2,3,4). In the studies, HU values and stone analysis were compared for the prediction of stone composition. The average mean HU was reported as 565-698 HU for cystine and 700-1438 HU for CaOX stones in different studies (5,6,7,8). In current patients, the mean HU value, HUdiff value, standard deviation (SD) value and stone analysis were detected as 1445 HU, 592 HU, 128 HU and CaOX for patient-1 and 662 HU, 236 HU, 52 HU and cystine for patient-2, respectively. In a recent study, stone heterogeneity index was described in ureteral stones by Lee et al. (9) and it was defined as the SD of HU on NCCT. They calculated minimum, maximum and SD of HU values on NCCT images. After the analysis, a strong relationship was found between a large SD of HU and stone heterogeneity in stone composition in their reports. In fact, our study supports this study. HUdiff provides similar indications to SD of HU value in recent and our studies. IMAGES IN CLINICAL UROLOGY Abstract ÖzHounsfield ünitesi (HU), üriner sistem taş dansitesinin kontrastsız bilgisayarlı tomografi (NCCT) değerlendirmesinde kantitatif veri ile tedavi başarı oranlarını gösterme yeteneğine sahiptir. Bu yazıda, iki hastanın NCCT'sinde HU değerleri arasındaki fark (HUdiff) ölçülmüştür. Bize göre, HUdiff değeri tedavi öncesi taş kompozisyonunu öngörebilmektedir. Anahtar Kelimeler: Hounsfield ünitesi, kontrastsız bilgisayarlı tomografi, taş kompozisyonu, böbrek taşı, taş homojenitesi/heterojenitesi Hounsfield units (HU) provides a quantitative assessment of stone density in the urogenital tract on non-contrast computed tomography (NCCT) and has the ability to predict treatment success. The difference in HU (HUdiff) value was measured on NCCT in two patients. Our opinion is that HUdiff can predict stone composition before treatment.

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Evaluation of computed tomography findings for success prediction after extracorporeal shock wave lithotripsy for urinary tract stone disease

Abstract: We suggest that HUmax, HUmin and HUave values are significant predictors of SWL success for both kidney and ureteral stones. They might be used in daily clinical practice for patient counselling.

Cited by 29 publications

References 16 publications

Computed tomography findings predicting the success of silodosin for medical expulsive therapy of ureteral stones

Computed tomography findings predicting the success of silodosin for medical expulsive therapy of ureteral stones

Effects of Laser Probes and Computed Tomography Findings on Ureterorenoscopic Laser Lithotripsy Success Rate, Laser Time, Laser Energy Level and Operative Time for Distal Ureteral Stones

The Role of Computed Tomography Findings in Prediction of Stone Composition

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