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Stone heterogeneity index as the standard deviation of Hounsfield units: A novel predictor for shock-wave lithotripsy outcomes in ureter calculi

 Joo Yong Lee  ;  Jae Heon Kim  ;  Dong Hyuk Kang  ;  Doo Yong Chung  ;  Dae Hun Lee  ;  Hae Do Jung  ;  Jong Kyou Kwon  ;  Kang Su Cho 
 SCIENTIFIC REPORTS, Vol.6 : 23988, 2016 
Journal Title
Issue Date
Adult ; Aged ; Cohort Studies ; Databases, Factual ; Female ; Humans ; Lithotripsy* ; Male ; Middle Aged ; Multivariate Analysis ; Radiographic Image Interpretation, Computer-Assisted ; Regression Analysis ; Reproducibility of Results ; Republic of Korea ; Tomography, X-Ray Computed ; Treatment Outcome ; Ureter/diagnostic imaging ; Ureter/physiopathology* ; Ureteral Calculi/diagnostic imaging* ; Ureteral Calculi/therapy
We investigated whether stone heterogeneity index (SHI), which a proxy of such variations, was defined as the standard deviation of a Hounsfield unit (HU) on non-contrast computed tomography (NCCT), can be a novel predictor for shock-wave lithotripsy (SWL) outcomes in patients with ureteral stones. Medical records were obtained from the consecutive database of 1,519 patients who underwent the first session of SWL for urinary stones between 2005 and 2013. Ultimately, 604 patients with radiopaque ureteral stones were eligible for this study. Stone related variables including stone size, mean stone density (MSD), skin-to-stone distance, and SHI were obtained on NCCT. Patients were classified into the low and high SHI groups using mean SHI and compared. One-session success rate in the high SHI group was better than in the low SHI group (74.3% vs. 63.9%, P = 0.008). Multivariate logistic regression analyses revealed that smaller stone size (OR 0.889, 95% CI: 0.841-0.937, P < 0.001), lower MSD (OR 0.995, 95% CI: 0.994-0.996, P < 0.001), and higher SHI (OR 1.011, 95% CI: 1.008-1.014, P < 0.001) were independent predictors of one-session success. The radiologic heterogeneity of urinary stones or SHI was an independent predictor for SWL success in patients with ureteral calculi and a useful clinical parameter for stone fragility.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Chung, Doo Yong(정두용)
Jung, Hae Do(정해도)
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
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