Shock Wave Lithotripsy Correlates With Stone Density on Preoperative Computerized Tomography

Perks, Alexandra E.; Gotto, Geoffrey; Teichman, Joel M.H.

doi:10.1016/j.juro.2007.05.043

Cited by 55 publications

(34 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Perks AE et al found that the stone-free rate for stones less than 1,000 HU was 46%; versus 17%; for stones 1,000 HU or greater (p = 0.01) this is less than our study where we have stone rate of 50% for stone density >1000HU. 24 From the present study results it is concluded that SSD <10 cm is predicting factor for fragmentation of stone by ESWL as well as it predicts outcome of ESWL. Present study results i.e.…”

Section: Discussionsupporting

confidence: 50%

Study of factors predicting clinical outcomes of extracorporeal shock wave lithotripsy in Indian patients with upper urinary tract calculi

Panchal

Krishnaswamy

Dabhade³

et al. 2018

Int Surg J

View full text Add to dashboard Cite

Background: Extracorporeal shock wave lithotripsy (ESWL) is an effective non-invasive method for managing urinary tract calculi. Present study was undertaken to evaluate factors that may influence ESWL clinical outcomes in Indian patients with urinary tract calculi.Methods: This prospective study was conducted at Department of Urology, Medical Trust Hospital Cochin, India in the period from September 2006 to March 2009. Sixty patients with upper urinary tract lithiasis having stone size between 5 to 25 mm were included and patients with ˃2 calculi, distal ureteric obstruction (not relieved), renal anomalies were excluded. All patients were treated with DIREX medical system lithotripter. Clinical outcome of ESWL was assessed by factors like site, size, density and skin-to-stone distance. After statistical analysis, p-value ≤0.05 was taken as the level of significance.Results: The overall success of ESWL was 82%. The final success of ESWL for sites like ureter, pelvis, mid or upper and lower calyx were 94.1%, 84%, 85.7% and 58% respectively (p = 0.095). The rate of fragmentation of stone after one session of ESWL for stone size ≤10 mm, 11 mm - 20 mm and ≥21 mm was 76.5%, 68.4% and 16.7% respectively (p=0.009). For stone density 751-1000 HU, 22.2% patients required ≥2 sessions to achieve stone free status (p<0.0005). Around 15.6% patients in skin-to-stone distance (SSD) ≤10cm required ≥2 sessions to achieve stone free status (p = 0.27).Conclusions: ESWL should be considered a primary modality of treatment in patients with calculi size ≤20 mm, density ≤ 1000 HU, pelvic, ureteric and upper and/or middle calyceal calculi and for SSD ≤10 cm.

show abstract

Section: Discussionsupporting

confidence: 50%

Study of factors predicting clinical outcomes of extracorporeal shock wave lithotripsy in Indian patients with upper urinary tract calculi

Panchal

Krishnaswamy

Dabhade³

et al. 2018

Int Surg J

View full text Add to dashboard Cite

show abstract

“…Hence, an inverse correlation between the HU value (which measures the compactness of the stones) and the ESWL success rate was demonstrated. 18 An interesting area of use for the HU value is in predicting the composition of calculus in urinary systems. In Demirel and Suma's study on this topic, the calculus of 87 patients were assessed.…”

Section: Discussionmentioning

confidence: 99%

Can the Hounsfield unit predict the success of medically expulsive therapy

Erturhan

Bayrak

Mete

et al. 2013

CUAJ

View full text Add to dashboard Cite

Background: We investigate the predictability of medical expulsive therapy (MET) success with alpha blockers based on Hounsfield unit (HU) values and Hounsfield density (HD) values measured by computed tomography (CT) for distal ureteral stones. Methods: Between July 2011 and May 2012, 44 patients (19 female and 25 male) with 5-to 10-mm stones in the distal ureters were included in this randomized prospective study. Non-contrast CT examinations were performed in these patients. HU and HD values of stones were calculated. Doxazosine, 4 mg/day orally, was administered as a single dose to all patients for MET. Results: Patients were divided into 2 groups. Group 1 included 18 patients (43.9%) with dropped stones with MET. Group 2 included 23 patients (56.1%) with no stone passage with MET. In Group 1, the mean stone size was 7.7 mm, the mean HU was 507, and the HD was 53.04/mm. In Group 2, the mean stone size was 8.25 mm, the mean HU was 625, and the mean HD was 61.54/mm. The HU and HD values in Group 2 were higher than in Group 1. However, there was no statistically significant difference (p = 0.85 and 0.93 for HU and HD, respectively). Interpretation: We found that HU and HD values cannot be used to predict the chances of success for MET. Although the sample size is appropriate for the study, further comparative studies involving more patients are warranted.

show abstract

“…NCCT is clearly superior to conventional plain abdominal radiography and IVP both in its capacity to aid in diagnosis of urolithiasis and in cost-effectiveness [9,10]. Several studies have identified stone attenuation as a predictor of SWL success [3][4][5][6][7]. As mentioned above, lower stone attenuation values are predictive of SWL success (Fig.…”

Section: Discussionmentioning

confidence: 93%

“…However, the valuable information obtained from noncontrast computed tomography (NCCT), including stone location, size, number, and obstructive grade, has an important role in treatment planning. Some reports have suggested that stone attenuation value on NCCT is an independent predictor of clinical outcome after SWL [3][4][5][6][7]. In the present study, we attempted to identify the radiographic parameters on NCCT that best predicted SWL success.…”

Section: Introductionmentioning

confidence: 95%

1461 Stone Attenuation Value and Cross-Sectional Area on Computed Tomography Predict the Success of Shock Wave Lithotripsy

Tanaka¹,

Yokota²,

Toyonaga³

et al. 2010

Journal of Urology

View full text Add to dashboard Cite

Purpose: To identify the parameters on noncontrast computed tomography (NCCT) that best predict the success of shock wave lithotripsy (SWL). Materials and Methods:We reviewed the records of 75 patients who underwent SWL for urinary calculi measuring 5 to 20 mm. Using NCCT images, we estimated the largest stone cross-sectional area and contoured the inner edge of the stone. Clinical outcome was classified as successful (stone-free or ＜4 mm in diameter) or failed (stone fragments, ≥4 mm). The impact of preoperative parameters was evaluated by univariate and multivariate analysis. Results: The overall success rate was 73.3%. Average stone attenuation value, stone length, and stone cross-sectional area in the success and failure groups were 627.4±166.5 HU (Hounsfield unit) vs. 788.1±233.9 HU (p=0.002), 11.7±3.8 mm vs. 14.2±3.6 mm (p=0.015), and 0.31±0.17 cm 2 vs. 0.57±0.41 cm 2 (p＜0.001), respectively. In the multivariate analysis, stone attenuation value was the only independent predictor of SWL success (p=0.023), although stone cross-sectional area had a tendency to be associated with SWL success (p=0.053). Patients were then classified into four groups by using cutoff values of 780 HU for stone attenuation value and 0.4 cm 2 for cross-sectional area. By use of these cutoff values, the group with a low stone attenuation value and a low cross-sectional area was more than 11.6 times as likely to have a successful result on SWL as were all other groups (odds ratio, 11.6; 95% confidence interval, 3.9 to 54.7; p＜0.001). Conclusions: Stone attenuation value and stone cross-sectional area are good predictors of extracorporeal SWL outcome.

show abstract

Shock Wave Lithotripsy Correlates With Stone Density on Preoperative Computerized Tomography

Cited by 55 publications

References 22 publications

Study of factors predicting clinical outcomes of extracorporeal shock wave lithotripsy in Indian patients with upper urinary tract calculi

Study of factors predicting clinical outcomes of extracorporeal shock wave lithotripsy in Indian patients with upper urinary tract calculi

Can the Hounsfield unit predict the success of medically expulsive therapy

1461 Stone Attenuation Value and Cross-Sectional Area on Computed Tomography Predict the Success of Shock Wave Lithotripsy

Contact Info

Product

Resources

About