Category: Imaging & Image Guided Therapy: New Therapies

MP4-13 - Initial Experience with Computed Tomography-Ultrasound Image Fusion Guided Percutaneous Nephrolithotomy (CT-US PCNL)

Fri, Sep 21
10:00 AM - 12:00 PM

Introduction & Objective :

CT-US image fusion guided renal access is an alternative US only or fluoroscopy only approaches for PCNL. This approach juxtaposes real time US with previously obtained reformatted CT scan images (Figure 1). This study is the first cohort study as we know to compare the efficacy and safety of CT - ultrasound image fusion technology and traditional ultrasound guided percutaneous nephrolithotomy.


Methods :

Twenty-four patients with renal stones admitted in Beijing Tsinghua Changgung hospital from September 2016 to February 2018 presenting were divided into CT-US image fusion guided or US only guided group in a ratio of 1:1 according to the stone size, age and gender. Patient and stone characteristics, perioperative outcomes, and complications were compared between the 2 groups. The primary end point of "stone-free" which was defined as no residual stone on KUB within 3 days postoperatively.


Results :

Two groups of patients had no significant statistical difference in the demographic and stone characteristics (P > 0.05). The average time to establishment of the fusion image process was 8.23 ±3.12 min. Compared with US only group, CT-US image fusion guided PCNL group had decreased the puncture time (150.85±169.07s vs 216.85±207.43s). There were no significant differences in estimated blood loss or primary stone-free rate or complication rate between the two methods, but the image fusion technology had a better incidence  trend of intraoperative complications and improved stone free rate.


Conclusions :

CT - ultrasound image fusion technology guide PCNL is a safe and reliable new technology. CT-US image fusion can decrease the puncture time compared with the US only group. There is no obvious difference efficacy and safety outcomes compared with the traditional US guided PCNL and CT-US guided, but with the increase of the number of cases imaging fusion techniques have increasing the calculi clearance rate trend.

Yuzhe Tang

Resident
Beijing Tsinghua Changgung Hospital
Beijing, Beijing, China (People's Republic)

Jianxing Li

Beijing, Beijing, China (People's Republic)