Variation Coefficient of Stone Density: A Novel Predictor of the Outcome of Extracorporeal Shockwave Lithotripsy

Yamashita, Shimpei; Kohjimoto, Yasuo; Iguchi, Takashi; Nishizawa, Satoshi; Iba, Akinori; Kikkawa, Kazuro; Hara, Isao

doi:10.1089/end.2016.0719

Cited by 36 publications

(22 citation statements)

References 26 publications

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“…VCSD = (standard deviation of stone density)/(mean stone density) × 100. It was found to be a stronger predictor of SWL success than mean stone density as measured by HU for upper urinary tract calculi, likely because it accounts for differences in composition and crystalline lattice of stones better than simple HU density averages do [54] .…”

Section: Stone Characteristicsmentioning

confidence: 95%

Indications and contraindications for shock wave lithotripsy and how to improve outcomes

Reynolds

Kroczak

Pace

2018

Asian Journal of Urology

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For over 35 years shock wave lithotripsy has proven to be an effective, safe and truly minimally invasive option for the treatment of nephrolithiasis. Various technical factors as well as patient selection can impact the success of the procedure. We used published work focusing on outcomes of shock wave lithotripsy, risk of complications, and strategies for improving stone fragmentation to create this review. Multiple patient and technical factors have been found to impact success of treatment. Skin to stone distance, stone density and composition, size and location of the stone within the urinary system all influence stone free rates. A slower rate with a gradual increasing voltage, precise targeting, proper coupling will improve stone fragmentation and decrease risk of complications. The selection of appropriate patients through a shared decision making process and attention to the technical factors that improve stone free rates is key to providing an effective treatment and patient satisfaction.

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Section: Stone Characteristicsmentioning

confidence: 95%

Indications and contraindications for shock wave lithotripsy and how to improve outcomes

Reynolds

Kroczak

Pace

2018

Asian Journal of Urology

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“…It will be necessary to carry out subgroup analysis by categorizing stone sizes in future large‐scale studies. Furthermore, the measurement values associated with stone heterogeneity, such as SHI and VCSD, have been reported to be useful for predicting SWL outcome . We need to investigate the usefulness of these values based on 3‐D stone images.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, several studies have assessed the predictive SWL success of non‐contrast CT parameters, such as SSD, MSD, SHI and VCSD . MSD is widely recognized as a significant predictor of SWL outcome among these parameters.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, several studies have assessed the predictive SWL success of non-contrast CT parameters, such as SSD, MSD, SHI and VCSD. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] MSD is widely recognized as a significant predictor of SWL outcome among these parameters. Patients with MSD >900-1000 HU have less successful SWL results, according to the American Urological Association guidelines.…”

Section: Introductionmentioning

confidence: 99%

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Three‐dimensional mean stone density measurement is superior for predicting extracorporeal shock wave lithotripsy success

et al. 2018

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Objectives The objective of the present study was to investigate the usefulness of three‐dimensional images of stones to measure mean stone density for predicting the outcome of shock wave lithotripsy. Methods We retrospectively identified 239 patients who underwent shock wave lithotripsy with pretreatment non‐contrast computed tomography. We automatically measured the mean stone density of three‐dimensional images of stones using a high‐functional viewer. For comparison, mean stone density was also measured by two previously reported techniques using both the abdominal windows and the bone windows on the axial slice at the level of the largest diameter of the stone. We compared the outcome predictive power after the first treatment with outcomes according to measurement by four other methods. We also carried out logistic regression analysis, including mean stone density measured by three‐dimensional images. Results The single treatment success rate was 48.5%. The effect size (14.148) of the mean stone density measured by three‐dimensional images was higher than those of the other four manual methods. In addition, the area under the curve (0.6330) of the mean stone density measured by three‐dimensional images was significantly higher than those of the other methods. Increasing stone volume (P = 0.002) and increasing mean stone density measured by three‐dimensional images (P = 0.023) were significant independent predictors of the treatment outcome on multivariate analysis. Conclusions This is the first study to compare the predictive powers for shock wave lithotripsy outcome of various mean stone density measuring methods. There is an indication that mean stone density automatically measured by three‐dimensional images of stones is more useful than other measuring methods for predicting outcomes of shock wave lithotripsy.

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“…Jacobs et al (2008) reported that the impact of SSD on SWL outcome varied by the type of lithotripter used [27]. Recent studies from Asian countries have also shown no association between SSD and SWL success [28–31]. This might be because the number of morbidly obese patients is relatively small in Asian countries.…”

Section: Skin-to-stone Distancementioning

confidence: 99%

Noncontrast Computed Tomography Parameters for Predicting Shock Wave Lithotripsy Outcome in Upper Urinary Tract Stone Cases

Yamashita

Kohjimoto

Iwahashi

et al. 2018

BioMed Research International

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Kidney stones are a major public health concern with continuously increasing worldwide prevalence. Shock wave lithotripsy (SWL) is the first line treatment choice for upper urinary tract calculi with ureteroscopy and has advantages of safety and noninvasiveness, but the treatment success rate of SWL is lower than that of other therapies. It is therefore important to identify predictive factors for SWL outcome and select a suitable treatment choice for patients with upper urinary tract calculi. In recent years, computed tomography (CT) has become the gold standard for diagnosis of upper urinary tract calculi. Several factors based on CT images, including skin-to-stone distance, mean stone density, stone heterogeneity index, and variation coefficient of stone density, have been reported to be useful for predicting SWL outcome. In addition, a new method of analysis, CT texture analysis, is reportedly useful for predicting SWL outcomes. This review aims to summarize CT parameters for predicting the outcome of shock wave lithotripsy in stone cases in the upper urinary tract.

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Variation Coefficient of Stone Density: A Novel Predictor of the Outcome of Extracorporeal Shockwave Lithotripsy

Abstract: We found that VCSD can be a novel predictor of SWL success. The development of nomograms or scoring systems, including VCSD, can assist in the decision process for patients and minimize unnecessary delay in treatment of urolithiasis.

Cited by 36 publications

References 26 publications

Indications and contraindications for shock wave lithotripsy and how to improve outcomes

Indications and contraindications for shock wave lithotripsy and how to improve outcomes

Three‐dimensional mean stone density measurement is superior for predicting extracorporeal shock wave lithotripsy success

Noncontrast Computed Tomography Parameters for Predicting Shock Wave Lithotripsy Outcome in Upper Urinary Tract Stone Cases

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