MP47-10 TWO-DIMENSIONAL SHEAR WAVE ELASTOGRAPHY: A PROMISING TOOL IN PREDICTING ADHERENT PERINEPHRIC FAT IN ROBOT-ASSISTED PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP47-10 TWO-DIMENSIONAL SHEAR WAVE ELASTOGRAPHY: A PROMISING TOOL IN PREDICTING ADHERENT PERINEPHRIC FAT IN ROBOT-ASSISTED PARTIAL NEPHRECTOMY Francesca Ambrosini, Francesco Chierigo, Veronica Giasotto, Guano Giovanni, Giovanni Marchi, Marco Martiriggiano, Giulia Carboni, Andrea Sorrentino, Guglielmo Mantica, Marco Borghesi, and Carlo Terrone Francesca AmbrosiniFrancesca Ambrosini More articles by this author , Francesco ChierigoFrancesco Chierigo More articles by this author , Veronica GiasottoVeronica Giasotto More articles by this author , Guano GiovanniGuano Giovanni More articles by this author , Giovanni MarchiGiovanni Marchi More articles by this author , Marco MartiriggianoMarco Martiriggiano More articles by this author , Giulia CarboniGiulia Carboni More articles by this author , Andrea SorrentinoAndrea Sorrentino More articles by this author , Guglielmo ManticaGuglielmo Mantica More articles by this author , Marco BorghesiMarco Borghesi More articles by this author , and Carlo TerroneCarlo Terrone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003293.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The Mayo Adhesive Probability (MAP) score predicts the presence of adherent perinephric fat (APF) which may increase the surgical complexity of partial nephrectomy. We assessed the role of 2D shear-wave elastography (SWE) in predicting the presence of APF with the goal to describe a novel model for the preoperative assessment of patients submitted to robot-assisted partial nephrectomy (RAPN). METHODS: Consecutive patients submitted to RAPN were prospectively enrolled between January 2021 and January 2022. Data were collected regarding patients’ characteristics, tumor features (RENAL, PADUA, SPARE score, MAP score ). Presence of APF was defined by the surgeon intraoperatively. Perirenal fat stiffness was preoperatively assessed with two-dimensional (2D) SWE. Each sampling was repeated 3 times and the mean value was recorded. We relied on multivariable logistic regression models to test whether APF was associated with higher values of mean SWE, gender, BMI, and MAP score. Models’ predictive ability of the presence of APF was assessed using the concordance index (C-index). Linear regression models investigated the association between APF and OT. RESULTS: 55 patients were collected of whom 31 (56%) did not have APF and 24 (44%) had APF. No statistically significant differences were reported among patients with or without APF with regards to age, preoperative creatinine and glomerular filtration rate, gender, BMI, smoking habit, diabetes, and cT stage. Hypertension was reported in 17 (71%) out of 24 patients with APF and in 13 (42%) patients out of 31 without APF (p=0.033).In single-variable analysis, there was a significantly increased likelihood of APF in males (92% VS 8,3% p=0.004) and in patients with a higher median (IQR) SWE (9.0 (8.0, 11.5) VS 5.8 (4.8, 7.0) p<0.001).MAP score had a good predictive ability of APF on its own (C-index = 0,876). The model including SWE alone had a similar predictive value (C-index = 0,84).The most effective model in predicting APF included SWE, gender and BMI (C-index = 0,91).The median (IQR) OT was 160 (132 – 182) minutes and 185 (179 – 222) minutes in patients without or with APF, respectively (p=0.01).The linear regression analysis showed that the presence of APF is associated with higher total OT (R squared = 0,097, p=0.012). CONCLUSIONS: The multivariable model including gender, BMI and the mean value of three measures of SWE highly predicts the presence of APF. The presence of APF impacts the total OT. A larger sample size is needed to validate the model and to create a score that effectively predicts APF. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e648 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francesca Ambrosini More articles by this author Francesco Chierigo More articles by this author Veronica Giasotto More articles by this author Guano Giovanni More articles by this author Giovanni Marchi More articles by this author Marco Martiriggiano More articles by this author Giulia Carboni More articles by this author Andrea Sorrentino More articles by this author Guglielmo Mantica More articles by this author Marco Borghesi More articles by this author Carlo Terrone More articles by this author Expand All Advertisement PDF downloadLoading ...