SWL literature
SWL Literature

Panthier F. et al., 2021: Evaluation of a free 3D software for kidney stones' surgical planning: "kidney stone calculator" a pilot study

Panthier F, Traxer O, Yonneau L, Lebret T, Berthe L, Illoul L, Timsit MO, Mejean A, Doizi S, Audenet F.
Service D'Urologie, Hôpital Européen Georges Pompidou, AP-HP, Centre-Université de Paris, 20 rue Leblanc, 75015, Paris, France.
GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.
GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.
Service D'Urologie, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France.
PIMMUMR 8006 CNRS-Arts Et Métiers ParisTech, 151 bd de l'Hôpital, 75013, Paris, France.
Service D'Urologie, Hôpital Foch-Université Paris Saclay-UVSQ, 40 rue Worth, 92150, Suresnes, France.
Service D'Urologie, Hôpital Européen Georges Pompidou, AP-HP, Centre-Université de Paris, 20 rue Leblanc, 75015, Paris, France.

Abstract

Introduction: Kidney Stone Calculator (KSC) is a free, three-dimensional (3D) planning software for flexible ureteroscopy(fURS) with Holmium:YAG(Ho:YAG) endocorporeal lithotripsy (EL). KSC provides the stone volume (SV) and expected duration of lithotripsy (ExDL) estimations based on non-enhanced-CT scan (NECT) DICOM series. We aimed to provide a preclinical and clinical evaluation of KSC.

Patients and methods: A preclinical evaluation measured the SV by three operators (resident, endourology expert and research engineer) among 17 NECT cases. Between January and March 2020, a multicentric, prospective, observational double-blind clinical evaluation was conducted in patients presenting with renal stones treated with Ho:YAG-EL during fURS and preoperative NECT. Demographic and surgical data were collected. The primary endpoint was a significant median difference between ExDL and EffectiveDL (EfDL). Second, efficiency (J/mm3) and efficacy (mm3/min) ratios were calculated.

Results: The preclinical evaluation showed no significant difference in the SV measurements among operators (p > 0.05). Pearson and Kendall coefficients of 0.99 and 0.98, respectively, were found. Twenty-six patients were included in the clinical evaluation, with a median age of 55 years. In 66% of cases, there was a single stone located in the lower pole, with a density > 1000 Hounsfield Unit observed in 42% and 85% of cases. A 14% [Q1-Q3 (5.4-24.8); p = 0.36] median difference between ExDL and EfDL was noted, which was greater in the case of lower pole stones with no possible relocation (p = 0.008). Median values of 17.6 J/mm3 and 0.4 (0.32-0.56) mm3/s EL were also noted.

Conclusions: Kidney Stone Calculator is a reproducible and accurate software that allows for an estimation of the stone burden and provides an ExDL for URSf. Defining the influencing factors of EL will improve its ExDL.

World J Urol. 2021 Mar 29. doi: 10.1007/s00345-021-03671-z. Online ahead of print. PMID: 33779821. FREE ARTICLE

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Comments 1

Peter Alken on Monday, August 09 2021 08:30

ESWL is not the topic of this paper. However, it would be interesting to see the technique being applied on stone disintegration with ESWL. I am sure to see such a paper soon.

Peter Alken

ESWL is not the topic of this paper. However, it would be interesting to see the technique being applied on stone disintegration with ESWL. I am sure to see such a paper soon. Peter Alken
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Sunday, December 05 2021

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