Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

The Predictive Role of Abdominal Fat Parameters and Stone Density on SWL Outcomes

Author(s): Coskun Kaya*, Yurdaer Kaynak, Aral Karabag and Aykut Aykaç

Volume 16, Issue 1, 2020

Page: [80 - 87] Pages: 8

DOI: 10.2174/1573405614666180927112127

Price: $65

Abstract

Background: Our aim was to detect the role of radiological abdominal fat parameters by tomography and stone density by plain X-ray on extracorporeal Shock Wave Lithotripsy (SWL) stone-free rate.

Methods: The patients who had undergone SWL for a single opaque renal stone < 2 cm in diameter and proximal ureteric stone < 1 cm in diameter were collected retrospectively. The characteristics of patients and stones were recorded. The stone attitude, HU, abdominal fat parameters, paraperirenal fat area, perirenal infiltration and severity of hydronephrosis with pre-treatment Non- Contrast Computed Tomography (NCCT) and stone density with radiography were evaluated by a radiologist. Four weeks after the last SWL; all patients were evaluated by plain X-ray and categorized as Stone Free (SF) and Residual Fragment (RF) group.

Results: 51 patients with renal stones and 88 patients with proximal ureteral stones were included in the study. 24 (47%) and 63 (71%) patients were classified as SFfor renal and ureteral stones respectively. Only stone size was an independent predictor for stone-free rates after SWL for renal and proximal ureteral stones on multivariate analysis. The Receiver Operating Characteristic (ROC) curves for renal calculi revealed that creatinine level, stone size, stone attitude, Houns-Field Unit (HU) and Skin-to-Stone Distance (SSD) were the predictive factors for the SWL outcome (p< 0.05). The ROC curve for ureteral calculi demonstrated that HU, stone size and attitude were the predictive factors (p< 0.05).

Conclusion: All abdominal fat parameters and the stone density were not related to SWL failure. A large follow-up with more patients is essential to confirm the role of radiological parameters on the outcome of SWL.

Keywords: Abdominal fat, computed tomography, extracorporeal shockwave lithotripsy, renal stones, stone density, ureteral stones.

Graphical Abstract

[1]
Albala DM, Assimos DG, Clayman RV, et al. Lower pole I: a prospective randomized trial of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy for lower pole nephrolithiasis-initial results. J Urol 2001; 166(6): 2072-80.
[http://dx.doi.org/10.1016/S0022-5347(05)65508-5] [PMID: 11696709]
[2]
Coz F, Orvieto M, Bustos M, et al. Extracorporeal shockwave lithotripsy of 2000 urinary calculi with the modulith SL-20: success and failure according to size and location of stones. J Endourol 2000; 14(3): 239-46.
[http://dx.doi.org/10.1089/end.2000.14.239] [PMID: 10795612]
[3]
Pace KT, Ghiculete D, Harju M, Honey RJ. Shock wave lithotripsy at 60 or 120 shocks per minute: a randomized, double-blind trial. J Urol 2005; 174(2): 595-9.
[http://dx.doi.org/10.1097/01.ju.0000165156.90011.95] [PMID: 16006908]
[4]
El-Nahas AR, El-Assmy AM, Mansour O, Sheir KZ. A prospective multivariate analysis of factors predicting stone disintegration by extracorporeal shock wave lithotripsy: the value of high-resolution noncontrast computed tomography. Eur Urol 2007; 51(6): 1688-93.
[http://dx.doi.org/10.1016/j.eururo.2006.11.048] [PMID: 17161522]
[5]
Weld KJ, Montiglio C, Morris MS, Bush AC, Cespedes RD. Shock wave lithotripsy success for renal stones based on patient and stone computed tomography characteristics. Urology 2007; 70(6): 1043-6.
[http://dx.doi.org/10.1016/j.urology.2007.07.074] [PMID: 18158009]
[6]
Lee HY, Yang YH, Lee YL, et al. Noncontrast computed tomography factors that predict the renal stone outcome after shock wave lithotripsy. Clin Imaging 2015; 39(5): 845-50.
[http://dx.doi.org/10.1016/j.clinimag.2015.04.010] [PMID: 25975631]
[7]
Pareek G, Armenakas NA, Panagopoulos G, Bruno JJ, Fracchia JA. Extracorporeal shock wave lithotripsy success based on body mass index and Hounsfield units. Urology 2005; 65(1): 33-6.
[http://dx.doi.org/10.1016/j.urology.2004.08.004] [PMID: 15667858]
[8]
Mezentsev VA. Extracorporeal shock wave lithotripsy in the treatment of renal pelvicalyceal stones in morbidly obese patients. Int Braz J Urol 2005; 31(2): 105-10.
[http://dx.doi.org/10.1590/S1677-55382005000200003] [PMID: 15877828]
[9]
Manikandan S. Data transformation. J Pharmacol Pharmacother 2010; 1(2): 126-7.
[http://dx.doi.org/10.4103/0976-500X.72373] [PMID: 21350629]
[10]
Geng JH, Tu HP, Shih PM, et al. Noncontrast computed tomography can predict the outcome of shockwave lithotripsy via accurate stone measurement and abdominal fat distribution determination. Kaohsiung J Med Sci 2015; 31(1): 34-41.
[http://dx.doi.org/10.1016/j.kjms.2014.10.001] [PMID: 25600918]
[11]
Dretler SP. Stone fragility-a new therapeutic distinction. J Urol 1988; 139(5): 1124-7.
[http://dx.doi.org/10.1016/S0022-5347(17)42801-1] [PMID: 3361657]
[12]
Bon D, Dore B, Irani J, Marroncle M, Aubert J. Radiographic prognostic criteria for extracorporeal shock-wave lithotripsy: a study of 485 patients. Urology 1996; 48(4): 556-60.
[http://dx.doi.org/10.1016/S0090-4295(96)00251-8] [PMID: 8886060]
[13]
Lim KH, Jung JH, Kwon JH, et al. Can stone density on plain radiography predict the outcome of extracorporeal shockwave lithotripsy for ureteral stones? Korean J Urol 2015; 56(1): 56-62.
[http://dx.doi.org/10.4111/kju.2015.56.1.56] [PMID: 25598937]
[14]
Celik S, Bozkurt O, Kaya FG, et al. Evaluation of computed tomography findings for success prediction after extracorporeal shock wave lithotripsy for urinary tract stone disease. Int Urol Nephrol 2015; 47(1): 69-73.
[http://dx.doi.org/10.1007/s11255-014-0857-0] [PMID: 25311505]
[15]
Pareek G, Hedican SP, Lee FT Jr, Nakada SY. Shock wave lithotripsy success determined by skin-to-stone distance on computed tomography. Urology 2005; 66(5): 941-4.
[http://dx.doi.org/10.1016/j.urology.2005.05.011] [PMID: 16286099]
[16]
Yoshizumi T, Nakamura T, Yamane M, et al. Abdominal fat: standardized technique for measurement at CT. Radiology 1999; 211(1): 283-6.
[http://dx.doi.org/10.1148/radiology.211.1.r99ap15283] [PMID: 10189485]
[17]
Goertz JK, Lotterman S. Can the degree of hydronephrosis on ultrasound predict kidney stone size? Am J Emerg Med 2010; 28(7): 813-6.
[http://dx.doi.org/10.1016/j.ajem.2009.06.028] [PMID: 20837260]
[18]
Turk C, Petrik A, Sarica K, et al. EAU Guidelines on urolithiasis. Eur Urol 2015; 69: 475-82.
[http://dx.doi.org/10.1016/j.eururo.2015.07.041] [PMID: 26344917]
[19]
Aeberli D, Müller S, Schmutz R, Schmid HP. Predictive value of radiological criteria for disintegration rates of extracorporeal shock wave lithotripsy. Urol Int 2001; 66(3): 127-30.
[http://dx.doi.org/10.1159/000056590] [PMID: 11316972]
[20]
Olcott EW, Sommer FG, Napel S. Accuracy of detection and measurement of renal calculi: in vitro comparison of three-dimensional spiral CT, radiography, and nephrotomography. Radiology 1997; 204(1): 19-25.
[http://dx.doi.org/10.1148/radiology.204.1.9205217] [PMID: 9205217]
[21]
Vakalopoulos I. Development of a mathematical model to predict extracorporeal shockwave lithotripsy outcome. J Endourol 2009; 23(6): 891-7.
[http://dx.doi.org/10.1089/end.2008.0465] [PMID: 19441881]
[22]
Sfoungaristos S, Hidas G, Gofrit ON, et al. Do we really need kidneys-ureters-bladder radiography to predict stone radiopacity before treatment with shockwave lithotripsy? Development and internal validation of a novel predictive model based on computed tomography parameters. J Endourol 2015; 29(5): 498-503.
[http://dx.doi.org/10.1089/end.2014.0190.ECC] [PMID: 25945651]
[23]
Ouzaid I, Al-qahtani S, Dominique S, et al. A 970 Hounsfield units (HU) threshold of kidney stone density on non-contrast computed tomography (NCCT) improves patients’ selection for Extracorporeal Shockwave Lithotripsy (ESWL): evidence from a prospective study. BJU Int 2012; 110(11 Pt B): E438-42.
[http://dx.doi.org/10.1111/j.1464-410X.2012.10964.x] [PMID: 22372937]
[24]
Juan HC, Lin HY, Chou YH, et al. Abdominal fat distribution on computed tomography predicts ureteric calculus fragmentation by shock wave lithotripsy. Eur Radiol 2012; 22(8): 1624-30.
[http://dx.doi.org/10.1007/s00330-012-2413-6] [PMID: 22415413]
[25]
Park HS, Gong MK, Yoon CY, Moon G, Cheon J, Choi YD. Computed tomography-based novel prediction model for the outcome of shockwave lithotripsy in proximal ureteral stones. J Endourol 2016; 30(7): 810-6.
[http://dx.doi.org/10.1089/end.2016.0056] [PMID: 27042952]
[26]
Joseph P, Mandal AK, Singh SK, Mandal P, Sankhwar SN, Sharma SK. Computerized tomography attenuation value of renal calculus: can it predict successful fragmentation of the calculus by extracorporeal shock wave lithotripsy? A preliminary study. J Urol 2002; 167(5): 1968-71.
[http://dx.doi.org/10.1016/S0022-5347(05)65064-1] [PMID: 11956419]
[27]
Wang LJ, Wong YC, Chuang CK, et al. Predictions of outcomes of renal stones after extracorporeal shock wave lithotripsy from stone characteristics determined by unenhanced helical computed tomography: a multivariate analysis. Eur Radiol 2005; 15(11): 2238-43.
[http://dx.doi.org/10.1007/s00330-005-2742-9] [PMID: 15806362]
[28]
Wiesenthal JD, Ghiculete D. D’A Honey RJ, Pace KT. Evaluating the importance of mean stone density and skin-to-stone distance in predicting successful shock wave lithotripsy of renal and ureteric calculi. Urol Res 2010; 38(4): 307-13.
[http://dx.doi.org/10.1007/s00240-010-0295-0] [PMID: 20625891]
[29]
Saw KC, McAteer JA, Fineberg NS, et al. Calcium stone fragility is predicted by helical CT attenuation values. J Endourol 2000; 14(6): 471-4.
[http://dx.doi.org/10.1089/end.2000.14.471] [PMID: 10954300]
[30]
Hammad FT, Al Najjar A. The effect of fat, muscle, and kidney on stone fragmentation by shockwave lithotripsy: an in vitro study. J Endourol 2010; 24(2): 289-92.
[http://dx.doi.org/10.1089/end.2009.0366] [PMID: 20078241]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy