Mohamed Samir et al., 2024: Can shear wave elastography predict the success of shock wave lithotripsy used in renal stones treatment? A prospective study
Mohamed Samir 1 , Abdelrahim Galaleldine 2 , Tarek El-Zayat 2 , Noha Diaa Eldin 2 , Mahmoud A Mahmoud 2 , Diaa Mostafa 2
Ain Shams University, Cairo, Egypt.
Ain Shams University, Cairo, Egypt.
Abstract
Objective: To evaluate the usage of shear wave elastography (SWE) in the prediction of the success rate of shock‑wave lithotripsy (SWL) treatment of renal stones.
Patients and methods: In the present study, SWL was performed for 100 patients presented with renal stones in the duration from May 2022 to August 2023. The patients were divided into 2 groups SWL responders and non-responders. The study compared between the 2 groups in terms of baseline parameters of the patients as age, sex, body mass index (BMI), stone size, stone location, stone density (HU), skin-to-stone distance (SSD), the degree of hydronephrosis and the stone elastography values.
Results: There was no statistically significant relation between stone-free rate and degree of obstruction (p = 0.628), stone size (p = 0.390) upper calyceal location (p = 0.17), middle calyceal location (p = 0.66), and renal pelvis location (p = 1.0). Nevertheless, a statistically significant relation was found as regards lower calyceal location, stone density (HU), and stone Elastography values using multivariate analysis.
Conclusions: Measurement of stone density by shear wave elastography (SWE) can be used as an alternative to HU in decision-making before SWL. SWL success depends mainly on stone site, HU, and SWE values.
World J Urol. 2024 Mar 15;42(1):160. doi: 10.1007/s00345-024-04855-z. PMID: 38488885 PMCID: PMC10943162 FREE FULL TEXT
Comments 1
It remains to be seen whether SWE will fulfil the expectations. It is at least something relatively new compared to the usual "stone density (HU)" talk (1).
There are only two previous papers on SWE, the very first one from 2016 in Russian (2) and a relatively recent one from Turkey (3) (Table1).
Demir et al. (3) claim that “SWE is not dependent on the user and the results obtained are accepted to be objective, referring to (4). This is not reflected in a review article on SWE, the interested reader might read to get some basic information on SWE (5).
It seems to me that, at present, the prediction of ESWL by SWE success will not achieve satisfactory precision because it is influenced by too many and too variable factors,
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2 Clinical implications of shear wave ultrasound elastography for evaluation of urinary stones. G Kraev I, Rudenko VI, Amosov AV, Krupinov GE, Ganzha TM. Urologiia. 2016 Nov;(5):16-20. PMID: 28248014.
3 Usability of shear wave elastography to predict the success of extracorporeal shock-wave lithotripsy: prospective pilot study. Demir M, Dere O, Yağmur İ, Katı B, Pelit ES, Albayrak İH, Çiftçi H. Urolithiasis. 2021 Jun;49(3):255-260. doi: 10.1007/s00240-020-01221-7. Epub 2020 Oct 26. PMID: 33104861.
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4 Ultrasound elastography: principles, techniques, and clinical applications. Dewall RJ. Crit Rev Biomed Eng. 2013;41(1):1-19. doi: 10.1615/critrevbiomedeng.2013006991. PMID: 23510006.
5 A review of physical and engineering factors potentially affecting shear wave elastography. Nitta N, Yamakawa M, Hachiya H, Shiina T. J Med Ultrason (2001). 2021 Oct;48(4):403-414. doi: 10.1007/s10396-021-01127-w. Epub 2021 Aug 28.
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6 Can shear wave elastography predict the success of shock wave lithotripsy used in renal stones treatment? A prospective study
Samir M, Galaleldine A, El-Zayat T, Diaa Eldin N, Mahmoud MA, Mostafa D.
World J Urol. 2024 Mar 15;42(1):160. doi: 10.1007/s00345-024-04855-z.
Peter Alken