Non-Contrast Computed Tomography Scan as a Predictor of Shock-Wave Lithotripsy Outcomes for the Treatment of Renal Stones

Galal, Ehab Mohamad; Fathelbab, Tarek Khalaf; Abdelhamid, Amr Mohamad

doi:10.3834/uij.1944-5784.2012.10.03

Cited by 2 publications

(4 citation statements)

References 12 publications

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“…7 ). The majority of these SWL-derived particles are significantly below the 3–4 mm-diameter detection limit of clinical non-contrast computer tomography scans 20 , 65 , 66 . As discussed here, results from the present study, as well as inference made from previous studies, indicate that these small SWL-derived particles are likely to increase the chance for post-SWL treatment stone recurrence 67 – 70 .…”

Section: Resultsmentioning

confidence: 96%

“…This is observed in all cohorts of sex, age, ethnicity, and race, while exhibiting substantial geographic variability that varies from 3 to 15% in the United States to 1–19% in Asia, 4% in South America, 5–10% in Europe, and 20–25% in the Middle East 1 – 14 . A significant proportion of the identification of these global increases in kidney stone incidence result from improved medical imaging using non-contrast computed tomography (NCCT) 15 – 20 . In addition, the accurate diagnosis of kidney stone disease is further complicated by uncertainties in diagnostic codes, self-reporting, stone terminology and classification, risk factor identification, and other uncertainties associated with the prediction and monitoring of stone recurrence 1 .…”

Section: Introductionmentioning

confidence: 99%

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GeoBioMed perspectives on kidney stone recurrence from the reactive surface area of SWL-derived particles

Todorov

Sivaguru

Krambeck

et al. 2022

Sci Rep

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Shock wave lithotripsy (SWL) is an effective and commonly applied clinical treatment for human kidney stones. Yet the success of SWL is counterbalanced by the risk of retained fragments causing recurrent stone formation, which may require retreatment. This study has applied GeoBioMed experimental and analytical approaches to determine the size frequency distribution, fracture patterns, and reactive surface area of SWL-derived particles within the context of their original crystal growth structure (crystalline architecture) as revealed by confocal autofluorescence (CAF) and super-resolution autofluorescence (SRAF) microscopy. Multiple calcium oxalate (CaOx) stones were removed from a Mayo Clinic patient using standard percutaneous nephrolithotomy (PCNL) and shock pulse lithotripsy (SPL). This produced approximately 4–12 mm-diameter PCNL-derived fragments that were experimentally treated ex vivo with SWL to form hundreds of smaller particles. Fractures propagated through the crystalline architecture of PCNL-derived fragments in a variety of geometric orientations to form rectangular, pointed, concentrically spalled, and irregular SWL-derived particles. Size frequency distributions ranged from fine silt (4–8 μm) to very fine pebbles (2–4 mm), according to the Wentworth grain size scale, with a mean size of fine sand (125–250 μm). Importantly, these SWL-derived particles are smaller than the 3–4 mm-diameter detection limit of clinical computed tomography (CT) techniques and can be retained on internal kidney membrane surfaces. This creates clinically undetectable crystallization seed points with extremely high reactive surface areas, which dramatically enhance the multiple events of crystallization and dissolution (diagenetic phase transitions) that may lead to the high rates of CaOx kidney stone recurrence after SWL treatment.

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Section: Resultsmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

GeoBioMed perspectives on kidney stone recurrence from the reactive surface area of SWL-derived particles

Todorov

Sivaguru

Krambeck

et al. 2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“…7). The majority of these SWL-derived particles are signi cantly below the 3-4mm-diameter detection limit of clinical non-contrast computer tomography scans 20,63,64 . As discussed here, results from the present study, as well as inference made from previous studies, indicate that these small SWL-derived particles are likely to increase the chance for post-SWL treatment stone recurrence [65][66][67][68] .…”

Section: Discussionmentioning

confidence: 99%

“…This is observed in all cohorts of sex, age, ethnicity, and race, while exhibiting substantial geographic variability that varies from 3-15% in the United States to 1-19% in Asia, 4% in South America, 5-10% in Europe, and 20-25% in the Middle East [1][2][3][4][5][6][7][8][9][10][11][12][13][14] . A signi cant proportion of the identi cation of these global increases in kidney stone incidence result from improved medical imaging using non-contrast computed tomography (NCCT) [15][16][17][18][19][20] . In addition, the accurate diagnosis of kidney stone disease is further complicated by uncertainties in diagnostic codes, self-reporting, stone terminology and classi cation, risk factor identi cation, and other uncertainties associated with the prediction and monitoring of stone recurrence 1 .…”

Section: Introductionmentioning

confidence: 99%

Size Frequency Distributions, Fracture Patterns, and Reactive Surface Area of Shock Wave Lithotripsy-Derived Particles: A GeoBioMed Perspective on Kidney Stone Recurrence

Todorov

Sivaguru

Krambeck³

et al. 2022

Preprint

View full text Add to dashboard Cite

Shock wave lithotripsy (SWL) is an effective and commonly applied clinical treatment for human kidney stones. Yet the success of SWL is counterbalanced by the risk of retained fragments causing recurrent stone formation, which may require retreatment. This study has applied GeoBioMed experimental and analytical approaches to determine the size frequency distribution, fracture patterns, and reactive surface area of SWL-derived particles within the context of their original crystal growth structure (crystalline architecture) as revealed by confocal autofluorescence (CAF) and super-resolution autofluorescence (SRAF) microscopy. Multiple calcium oxalate (CaOx) stones were removed from a Mayo Clinic patient using standard percutaneous nephrolithotomy (PCNL) and shock pulse lithotripsy (SPL). This produced approximately 4-12mm-diameter PCNL-derived fragments that were experimentally treated ex vivo with SWL to form hundreds of smaller particles. Fractures propagated through the crystalline architecture of PCNL-derived fragments in a variety of geometric orientations to form rectangular, pointed, concentrically spalled, and irregular SWL-derived particles. Size frequency distributions ranged from fine silt (4-8mm) to very fine pebbles (2-4mm), according to the Wentworth grain size scale, with a mean size of fine sand (125-250mm). Importantly, these SWL-derived particles are smaller than the 3-4mm-diameter detection limit of clinical microcomputed tomography (micro-CT) techniques and can be retained on internal kidney membrane surfaces. This creates clinically undetectable crystallization seed points with extremely high reactive surface areas, which dramatically enhance the multiple events of crystallization and dissolution (diagenetic phase transitions) that may lead to the high rates of CaOx kidney stone recurrence after SWL treatment.

show abstract

Non-Contrast Computed Tomography Scan as a Predictor of Shock-Wave Lithotripsy Outcomes for the Treatment of Renal Stones

Cited by 2 publications

References 12 publications

GeoBioMed perspectives on kidney stone recurrence from the reactive surface area of SWL-derived particles

GeoBioMed perspectives on kidney stone recurrence from the reactive surface area of SWL-derived particles

Size Frequency Distributions, Fracture Patterns, and Reactive Surface Area of Shock Wave Lithotripsy-Derived Particles: A GeoBioMed Perspective on Kidney Stone Recurrence

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