Category: Clinical Stones: SWL
Introduction & Objective :
To explore whether CT texture analysis (CTTA) technique can help for predicting the curative effects of proximal ureteral stones by the Single Extracorporeal Shock-wave Lithotripsy (ESWL).
Methods : All the 100 proximal ureteral stones patients were performed non-enhanced Multi-Detector Computed Tomography (MDCT) before ESWL. The patients were divided to success and failure group. Success of ESWL was defined as patients being stone-free or having residual stone fragments ≤3 mm.Traditional characteristics (Stone size, body mass index (BMI), skin-to-stone distance (SSD)), and CTTA metrics such as Mean Hounsfield Unit (HU) density, Entropy, Kurtosis, skewness were analysed and compared between two groups by univariate and multiple logistic regression analysis. Receiver operator characteristic (ROC) curves were generated to determine Youden index-based cutoff values.
Failure of stone exclusion was observed in 36 patients (36%). Stone height, Stone cross-sectional diameter, The largest cross-sectional area, Stone volume, stone density (Mean HU), and CTTA metrics (kurtosis, entropy) were the significant independent predictors of ESWL success by the Univariate analysis(p<0.05). By the multiple logistic regression analysis, the Mean HU, skewness and kurtosis were showed to be the significant predictors of ESWL success(p<0.05). In the subgroup analysis based on cut-off value of mean stone density (HU=857), the only significant independent factor for both subgroups was kurtosis>-0.95 (p<0.05)
As a quantitative analysis method, CTTA may be helpful to select appropriate ESWL patients. High kurtosis and low mean HU simultaneously indicated relatively higher ESWL success rate.
Yang Xun– Wuhan, Hubei, China (People's Republic)
Cong Li– Wuhan, Hebei, China (People's Republic)
Yue Wu– Wuhan, Hubei, China (People's Republic)
Xiang Wang– Wuhan, Hubei, China (People's Republic)
Fan Xiao– Wuhan, Hubei, China (People's Republic)
Shaogang Wang– Wuhan, Hubei, China (People's Republic)