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

Shock wave lithotripsy (SWL) is a noninvasive and safe treatment for small renal stones. In unsuccessful cases, retreatment procedures are needed after SWL. According to the previous studies, patient and stone descriptors are good predictors of SWL success. Some stone and kidney descriptors are measured from renal Non-Contrast Computed Tomography (NCCT) images. It is a tedious, time-consuming and error-prone process with large inter-user variability when performed manually. In this study, novel features are proposed automatically extracted from NCCT images to describe morphology and location of renal stones and kidneys to predict retreatments after SWL. The proposed features can distinguish between different kidney and stone morphologies and locations while being less sensitive to image segmentation errors. These features are added to other stone and patient features to predict retreatment within 3 months after SWL. The experimental results show that using the proposed stone features extracted from NCCT images can improve the accuracy of predicting retreatment.

Download Full-text

A Prospective Longitudinal Study onthe Predictability of Quadruple-D Score in the Success Rate of Extracorporeal Shock Wave Lithotripsy for Renal Stones 1-2cm in Diameter

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48698.14919 ◽

2021 ◽

Author(s):

Soumish Sengupta ◽

Supriya Basu ◽

Kadambari Ghosh

Keyword(s):

Computed Tomography ◽

Shock Wave ◽

Scoring System ◽

Shock Wave Lithotripsy ◽

Renal Stones ◽

Extracorporeal Shock Wave ◽

Group A ◽

Group B ◽

Stone Density ◽

Free Status

Introduction: Quadruple-D, based on Computed Tomography (CT) derived metrics, is a scoring system that helps urologists to predict the Stone Free Rate (SFR) following Extracorporeal Shock Wave Lithotripsy (ESWL) in renal stones. Aim: To evaluate the efficacy of Quadruple-D scoring system to assess the SFR in individuals with renal stones measuring 1-2 cm in diameter after giving ESWL. Materials and Methods: The study was conducted on 120 patients. Systemic random sampling technique was applied with a sampling interval of two. Quadruple-D scoring, comprising of four Computed Tomography (CT) based metrics that is stonedimension, stone density, Hounsfield units (HU), Skin-to-Stone Distance (SSD) and stone location, was done prior to ESWL. The scores ranged from zero (worst) to four (best) points. Plain abdominal radiography was done three weeks after ESWL to assess SFR. Complete clearance was considered the stone free status. Patients were divided into group A with complete stone clearance and group B with residual stone. All the statistical analysis was done using IBM SPSS 26.0. Student’s t-test or Mann-Whitney U-test was used to compare continuous variables. Fisher’s-exact test and Chi-square test were used to analyse the cross charts between two categories. Results:The mean ellipsoid Stone Volume (SV) was 396.44±163.23 mm3 and 395.81±227.52 mm3 in group A and B, respectively. The stone density was 724.28±210.90 in group A and 814.56±190.63 in group B. In group A, 9.20% and in group B, 34.09% of the patients had stones in lower calyx. The difference between the groups based on the above parameters were statistically significant. The Quadruple-D score was 2.09±0.65 and 1.54±0.79 in group A and B, respectively. The Area Under the Curve (AUC) of Quadruple-D scoring system was 0.674. The age, sex, BMI, laterality of the stone and SSD did not predict stone-free status in this study. Conclusion: Quadruple-D scoring system has been successfully validated as the SFR showed a parallel increase with every positive component. Quadruple-D is an easy to use clinical tool to predict the success rate of ESWL.

Download Full-text