Clinical utility of computed tomography Hounsfield characterization for percutaneous nephrolithotomy: a cross-sectional study

Autor: Andrea Gallioli, Elisa De Lorenzis, Luca Boeri, Maurizio Delor, Stefano Paolo Zanetti, Fabrizio Longo, Alberto Trinchieri, Emanuele Montanari
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: BMC Urology, Vol 17, Iss 1, Pp 1-7 (2017)
Druh dokumentu: article
ISSN: 1471-2490
DOI: 10.1186/s12894-017-0296-1
Popis: Abstract Background Computed Tomography (CT) is considered the gold-standard for the pre-operative evaluation of urolithiasis. However, no Hounsfield (HU) variable capable of differentiating stone types has been clearly identified. The aim of this study is to assess the predictive value of HU parameters on CT for determining stone composition and outcomes in percutaneous nephrolithotomy (PCNL). Methods Seventy seven consecutive cases of PCNL between 2011 and 2016 were divided into 4 groups: 40 (52%) calcium, 26 (34%) uric acid, 5 (6%) struvite and 6 (8%) cystine stones. All images were reviewed by a single urologist using abdomen/bone windows to evaluate: stone volume, core (HUC), periphery HU and their absolute difference. HU density (HUD) was defined as the ratio between mean HU and the stone’s largest diameter. ROC curves assessed the predictive power of HU for determining stone composition/stone-free rate (SFR). Results No differences were found based on the viewing window (abdomen vs bone). Struvite stones had values halfway between hyperdense (calcium) and low-density (cystine/uric acid) calculi for all parameters except HUD, which was the lowest. All HU variables for medium-high density stones were greater than low-density stones (p
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