MP55-18 PREDICTING URETEROSOCPIC LITHOTRIPSY OUTCOME BY THREE-DIMENTIONAL MEAN STONE DENSITY

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy II1 Apr 2018MP55-18 PREDICTING URETEROSOCPIC LITHOTRIPSY OUTCOME BY THREE-DIMENTIONAL MEAN STONE DENSITY Yuya Iwahashi, Simpei Yamashita, Takashi Iguchi, Akinori Iba, Yasuo Kohjimoto, and Isao Hara Yuya IwahashiYuya Iwahashi More articles by this author , Simpei YamashitaSimpei Yamashita More articles by this author , Takashi IguchiTakashi Iguchi More articles by this author , Akinori IbaAkinori Iba More articles by this author , Yasuo KohjimotoYasuo Kohjimoto More articles by this author , and Isao HaraIsao Hara More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1789AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Mean stone density (MSD) is widely recognized as a significant predictor of shock wave lithotripsy outcome. However, the association between MSD and ureteroscopic lithotripsy outcome remains controversial. One of the reasons why this controversy exists is that measuring methods of MSD are not standardized in previous studies. In addition, manual measuring methods previously reported could lead to measurement bias between measurers. The purpose of this study was to measure MSD using three-dimentional stone images automatically (3D-MSD) and to investigate whether 3D-MSD can predict ureteroscopic lithotripsy success. METHODS We retrospectively identified 218 patients who underwent ureteroscopic lithotripsy for kidney stone (n=75) and ureteral stone (n=143) between February 2011 and April 2017 with pretreatment non-contrast computed tomography (NCCT) at our hospital. Stone volume and 3D-MSD were automatically measured using high functional viewer. We performed logistic regression analysis to identify factors contributing to treatment failure. Treatment failure was determined as residual fragments =4mm using NCCT or KUB within three months after operation. RESULTS Treatment failure rate was 20.1% (44/218 cases). Table 1 shows the difference of patient demographics and stone characteristics between treatment success group and treatment failure group. Patients in treatment failure group had higher percentage of kidney stones (<0.01) and multiple stones (p<0.01), larger stone volume (p<0.01) and larger 3D-MSD (p<0.01). Multivariate analysis revealed that renal stone (p<0.01), multiple stones (p<0.01), stone volume (p=0.02) and 3D-MSD (p=0.02) independently predicted the outcome (Table 2). The area under curve of 3D-MSD was 0.685 and the optimal cutoff value of 3D-MSD was 473HU. CONCLUSIONS The result of our study suggests that 3D-MSD is useful for predicting ureteroscopic lithotripsy outcome. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e754-e755 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Yuya Iwahashi More articles by this author Simpei Yamashita More articles by this author Takashi Iguchi More articles by this author Akinori Iba More articles by this author Yasuo Kohjimoto More articles by this author Isao Hara More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...