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Utility and limitation of cumulative stone diameter in predicting urinary stone burden at flexible ureteroscopy with holmium laser lithotripsy: a single-center experience.

Ito H, Kawahara T, Terao H, Ogawa T, Yao M, Kubota Y, Matsuzaki J - PLoS ONE (2013)

Bottom Line: To retrospectively assess the clinical utility in ureteroscopy (URS) planning of cumulative stone diameter (CSD), which does not account for stone width or depth, as a predictor of URS outcome and compare it with stone volume.To identify stone number impact on CSD, the AUROC of CSD divided by stone number was evaluated.In cases with CSD <20.0 mm or 1-3 stones, CSD was as valid a predictor of preoperative stone burden as stone volume, so preoperative kidney-ureter-bladder (KUB) films may be sufficient.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Ohguchi East General Hospital, Yokohama City, Japan. pug_daikichi@yahoo.co.jp

ABSTRACT

Purpose: To retrospectively assess the clinical utility in ureteroscopy (URS) planning of cumulative stone diameter (CSD), which does not account for stone width or depth, as a predictor of URS outcome and compare it with stone volume.

Materials and methods: Patients with renal stones treated at a single institute by flexible URS were retrospectively evaluated. To assess the clinical utility of CSD, relationships between stone-free (SF) status and stone burden (CSD and volume) were analyzed using the area under the receiver operating characteristics (AUROC) curve. To identify stone number impact on CSD, the AUROC of CSD divided by stone number was evaluated. Correlation coefficients of CSD and stone volume were also calculated for groups by stone number.

Results: In cases with CSD <20.0 mm, CSD and stone volume revealed equal ability to predict SF status. In cases with CSD ≥20.0 mm, stone volume showed higher predictive ability. The ROC curves for cases with ≥4 stones showed that CSD was less predictive of SF status than stone volume. The correlation coefficients of CSD and stone volume by stone number were 0.922 for 1 stone, 0.900 for 2-3 stones, and 0.661 for ≥4 stones.

Conclusions: In cases with CSD ≥20.0 mm or ≥4 stones, we should evaluate stone volume for a more predictive stone burden, and pretreatment non-contrast CT seems sufficient. In cases with CSD <20.0 mm or 1-3 stones, CSD was as valid a predictor of preoperative stone burden as stone volume, so preoperative kidney-ureter-bladder (KUB) films may be sufficient.

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Value of the area under the receiver operating characteristic (AUROC) curve of cumulative stone diameter (CSD) and stone volume in all cases, divided by stone diameter (<20.0 mm/≥20.0 mm) and number (1, 2–3, ≥4).
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pone-0065060-g002: Value of the area under the receiver operating characteristic (AUROC) curve of cumulative stone diameter (CSD) and stone volume in all cases, divided by stone diameter (<20.0 mm/≥20.0 mm) and number (1, 2–3, ≥4).

Mentions: The values for the AUROC curve [12] of the two parameters of stone burden are shown in Fig. 2. In all cases, these two parameters were highly indicative of SF status, and the correlation coefficient for CSD and stone volume was 0.835. In cases with CSD <20.0 mm, the two parameters demonstrated equal ability to predict SF status (Fig. 2). In cases with CSD ≥20.0 mm, however, stone volume showed higher predictive ability than the CSD (Fig. 2). The correlation coefficient for CSD and stone volume divided into stone number were 0.712 for patients with CSD <20.0 mm and 0.596 for patients with CSD ≥20.0 mm.


Utility and limitation of cumulative stone diameter in predicting urinary stone burden at flexible ureteroscopy with holmium laser lithotripsy: a single-center experience.

Ito H, Kawahara T, Terao H, Ogawa T, Yao M, Kubota Y, Matsuzaki J - PLoS ONE (2013)

Value of the area under the receiver operating characteristic (AUROC) curve of cumulative stone diameter (CSD) and stone volume in all cases, divided by stone diameter (<20.0 mm/≥20.0 mm) and number (1, 2–3, ≥4).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3672212&req=5

pone-0065060-g002: Value of the area under the receiver operating characteristic (AUROC) curve of cumulative stone diameter (CSD) and stone volume in all cases, divided by stone diameter (<20.0 mm/≥20.0 mm) and number (1, 2–3, ≥4).
Mentions: The values for the AUROC curve [12] of the two parameters of stone burden are shown in Fig. 2. In all cases, these two parameters were highly indicative of SF status, and the correlation coefficient for CSD and stone volume was 0.835. In cases with CSD <20.0 mm, the two parameters demonstrated equal ability to predict SF status (Fig. 2). In cases with CSD ≥20.0 mm, however, stone volume showed higher predictive ability than the CSD (Fig. 2). The correlation coefficient for CSD and stone volume divided into stone number were 0.712 for patients with CSD <20.0 mm and 0.596 for patients with CSD ≥20.0 mm.

Bottom Line: To retrospectively assess the clinical utility in ureteroscopy (URS) planning of cumulative stone diameter (CSD), which does not account for stone width or depth, as a predictor of URS outcome and compare it with stone volume.To identify stone number impact on CSD, the AUROC of CSD divided by stone number was evaluated.In cases with CSD <20.0 mm or 1-3 stones, CSD was as valid a predictor of preoperative stone burden as stone volume, so preoperative kidney-ureter-bladder (KUB) films may be sufficient.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Ohguchi East General Hospital, Yokohama City, Japan. pug_daikichi@yahoo.co.jp

ABSTRACT

Purpose: To retrospectively assess the clinical utility in ureteroscopy (URS) planning of cumulative stone diameter (CSD), which does not account for stone width or depth, as a predictor of URS outcome and compare it with stone volume.

Materials and methods: Patients with renal stones treated at a single institute by flexible URS were retrospectively evaluated. To assess the clinical utility of CSD, relationships between stone-free (SF) status and stone burden (CSD and volume) were analyzed using the area under the receiver operating characteristics (AUROC) curve. To identify stone number impact on CSD, the AUROC of CSD divided by stone number was evaluated. Correlation coefficients of CSD and stone volume were also calculated for groups by stone number.

Results: In cases with CSD <20.0 mm, CSD and stone volume revealed equal ability to predict SF status. In cases with CSD ≥20.0 mm, stone volume showed higher predictive ability. The ROC curves for cases with ≥4 stones showed that CSD was less predictive of SF status than stone volume. The correlation coefficients of CSD and stone volume by stone number were 0.922 for 1 stone, 0.900 for 2-3 stones, and 0.661 for ≥4 stones.

Conclusions: In cases with CSD ≥20.0 mm or ≥4 stones, we should evaluate stone volume for a more predictive stone burden, and pretreatment non-contrast CT seems sufficient. In cases with CSD <20.0 mm or 1-3 stones, CSD was as valid a predictor of preoperative stone burden as stone volume, so preoperative kidney-ureter-bladder (KUB) films may be sufficient.

Show MeSH
Related in: MedlinePlus