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World Journal of Urology

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01-12-2018 | Original Article

Advanced non-contrasted computed tomography post-processing by CT-Calculometry (CT-CM) outperforms established predictors for the outcome of shock wave lithotripsy

Authors: J. Langenauer, P. Betschart, L. Hechelhammer, S. Güsewell, H. P. Schmid, D. S. Engeler, D. Abt, V. Zumstein

Published in: World Journal of Urology | Issue 12/2018

Abstract

Objectives

To evaluate the predictive value of advanced non-contrasted computed tomography (NCCT) post-processing using novel CT-calculometry (CT-CM) parameters compared to established predictors of success of shock wave lithotripsy (SWL) for urinary calculi.

Materials and Methods

NCCT post-processing was retrospectively performed in 312 patients suffering from upper tract urinary calculi who were treated by SWL. Established predictors such as skin to stone distance, body mass index, stone diameter or mean stone attenuation values were assessed. Precise stone size and shape metrics, 3-D greyscale measurements and homogeneity parameters such as skewness and kurtosis, were analysed using CT-CM. Predictive values for SWL outcome were analysed using logistic regression and receiver operating characteristics (ROC) statistics.

Results

Overall success rate (stone disintegration and no re-intervention needed) of SWL was 59% (184 patients). CT-CM metrics mainly outperformed established predictors. According to ROC analyses, stone volume and surface area performed better than established stone diameter, mean 3D attenuation value was a stronger predictor than established mean attenuation value, and parameters skewness and kurtosis performed better than recently emerged variation coefficient of stone density. Moreover, prediction of SWL outcome with 80% probability to be correct would be possible in a clearly higher number of patients (up to fivefold) using CT-CM-derived parameters.

Conclusions

Advanced NCCT post-processing by CT-CM provides novel parameters that seem to outperform established predictors of SWL response. Implementation of these parameters into clinical routine might reduce SWL failure rates.

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Title: Advanced non-contrasted computed tomography post-processing by CT-Calculometry (CT-CM) outperforms established predictors for the outcome of shock wave lithotripsy
Authors: J. Langenauer
P. Betschart
L. Hechelhammer
S. Güsewell
H. P. Schmid
D. S. Engeler
D. Abt
V. Zumstein
Publication date: 01-12-2018
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 12/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-018-2348-x

At a glance: The STEP trials

Springer Medicine

Advanced non-contrasted computed tomography post-processing by CT-Calculometry (CT-CM) outperforms established predictors for the outcome of shock wave lithotripsy

Abstract

Objectives

Materials and Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Materials and Methods

Results

Conclusions

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