Abstract
PurposeTo assess the usefulness of factors unique to NCCT for the prediction of ESWL outcomes in patients with pancreatic duct stones.Materials and methodsWe retrospectively evaluated 148 patients with multiple PDS who had undergone ESWL therapy. All patients received an examination for NCCT both before and after ESWL. The following parameters were measured and recorded: patient characteristics including sex and age; NCCT parameters including mean stone length, mean stone volumes before and after ESWL, mean value of CT attenuation, standard deviation of CT attenuation, variation coefficient of CT attenuation, skin-to-stone distance, and pancreatic duct diameter; ESWL outcome indexes including stone clearance rate calculated using the formula frac{V0 - V1}{V0} times 100%, and the number of ESWL sessions. All patients were divided into groups based on their SCR: A group (SCR ≥ 90%), B group (SCR between 50% and 90%), and C group (SCR < 50%). Analysis of variance was used among the three groups to evaluate the potential predictors of SCR, and a receiver-operating curve was established to determine the optimal cutoff value.ResultsANOVA analysis revealed that MSD was the only significant predictor for SCR (p < 0.05), and ROC indicated an optimal cutoff value of +1000.45 HU, with a sensitivity up to 78.0% and specificity of 48.6%. Stones with MSD lower than +1000.45 HU had higher SCR (69.3%) than that of higher-density ones (59.6%). Pearson correlation analysis and histogram indicated a significant positive correlation between ESWL No. and MSL (r = 0.536), MSD (r = 0.250), SDSD (r = 0.247), and PDD (r = 0.227), all values being p < 0.01.ConclusionMSD is the optimal predictor of ESWL efficacy, and PDS with lower MSD had a better clearance rate with fewer fragmentation sessions.
Highlights
ObjectivesOur aim was to analyze stone characteristics obtained from Noncontrast Computed Tomography (NCCT) images and find positive pretreatment predictors for Extracorporeal shock wave lithotripsy (ESWL) efficacy in terms of stone clearance rate (SCR) and the number of ESWL sessions (ESWL No.)
analysis of viariance (ANOVA) analysis revealed that Mean stone density (MSD) was the only significant predictor for stone clearance rate (SCR) (p < 0.05), and receiver-operating characteristic (ROC)
It is crucial that we complete a pretreatment investigation of stone characteristics most predictive of Extracorporeal shock wave lithotripsy (ESWL) outcomes to devise an optimal treatment strategy for each pancreatic duct stones (PDS) case
Summary
Our aim was to analyze stone characteristics obtained from NCCT images and find positive pretreatment predictors for ESWL efficacy in terms of stone clearance rate (SCR) and the number of ESWL sessions (ESWL No.)
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