Laser lithotripsy for proximal ureteral calculi in adults: can 3D CT texture analysis help predict treatment success?
- 19.11.2020
- Urogenital
Erschienen in:
- Verfasst von
- Rui Wang
- Yunshan Su
- Chongwen Mao
- Song Li
- Mengjing You
- Shutian Xiang
- Erschienen in
- European Radiology | Ausgabe 6/2021
Abstract
Objective
To explore whether multiple 3D computed tomography texture analysis (3D-CTTA) parameters can predict the therapeutic effects of holmium: YAG laser lithotripsy (LL) on ureteral calculi.
Methods
The files from 94 patients (102 stones) with proximal ureteral calculi treated only by LL at a single institution were retrospectively retrieved from January 2016 to March 2019. According to intra-operative observations and postoperative reexamination, samples were divided into a completely crushed and a non-crushed group. Preoperative non-contrast-enhanced computed tomography (NCCT) images obtained by multiple CT scanners were imported to MaZda software for 3D texture analysis (TA). The CT-derived value of each target stone was measured, and 15 TA parameters were extracted by delineating volumes of interest (VOIs). Receiver operating characteristic (ROC) curves were drawn to determine the optimal critical value of each parameter based on the Youden index, and univariable and multivariable logistic regression analyses determined the significant factors for LL success.
Results
In univariable analysis, significant differences (p < 0.05) were observed among 7 parameters. In multivariable analysis, Perc.01 3D > 2062 (p = 0.03) and Z-fraction of image in runs (Z-Fraction) > 0.45570 (p = 0.009) were significant independent predictors, with odds ratios (ORs) of 24.204 and 60.329, respectively. In subgroup analysis based on the cutoff value of the CT-derived value (HU = 960), Perc.01 3D (OR = 44.154, 95% CI (2.379, 819.618), p = 0.011) and Z-Fraction (OR = 14.519, 95% CI (2.088, 100.953), p = 0.007) remained statistically significant.
Conclusions
The combination of 3D-CTTA parameters and the CT-derived value can be used as a quantitative reference to predict whether a target stone could be completely crushed by LL.
Key Points
• Computed tomography texture analysis (CTTA) may be helpful in selecting suitable laser lithotripsy (LL) patients.
• 3D-CTTA better predicts stone fragility than commonly used methods (such as the CT-derived value).
• The combination of CTTA and the CT-derived value can be used as a preoperative quantitative reference.
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- Titel
- Laser lithotripsy for proximal ureteral calculi in adults: can 3D CT texture analysis help predict treatment success?
- Verfasst von
-
Rui Wang
Yunshan Su
Chongwen Mao
Song Li
Mengjing You
Shutian Xiang
- Publikationsdatum
- 19.11.2020
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
European Radiology / Ausgabe 6/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084 - DOI
- https://doi.org/10.1007/s00330-020-07498-x
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