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Correlative investigation between routine clinical parameters of dual-energy computed tomography and the outcomes of extracorporeal shock wave lithotripsy in children with urolithiasis: a retrospective study

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the associations of DECT parameters with extracorporeal shock wave lithotripsy (ESWL) outcomes in pediatric patients.

Methods

A retrospective study of consecutive patients with calculi who underwent ESWL and DECT in our hospital was performed in 2011–2019. The primary outcome was DECT imaging’s correlation with ESWL outcomes. The secondary outcome was to determine DECT parameters independently predicting ESWL outcomes, including stone-free (SF) and residual stone (RS) statuses.

Results

The study included 207 patients. The mean CT attenuations at 140 kVp, 80 kVp, and 120 kVp and effective atomic number (Zeff) were significantly correlated with stone free (SF) and residual stone (RS) (P < 0.05). Areas under the curves (AUCs) of CT attenuations at 120 kVp, 80 kVp, 140 kVp, and dual-energy index (DEI) were 0.784 (95% CI 0.672–0.897), 0.780 (95% CI 0.677–0.884), 0.766 (95% CI 0.658–0.885), and 0.709 (95% CI 0.578–0.840) (all P < 0.05). With cutoffs of 882.5, 1330.5, 1042.5, and 0.103 for CT attenuations at 140 kVp, 80 kVp, 120 kVp, and DEI, respectively, sensitivities and specificities were 75.0% and 31.1%, 83.3% and 31.8%, 80.3% and 31.1%, and 58.3% and 44.7%, respectively.

Conclusion

Our results demonstrated that the parameters of DECT could be used to predict ESWL outcomes (especially the SF status) in children with urolithiasis. ESWL success can be accurately predicted by DECT, and it is hard to predict ESWL failure.

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Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was supported by the scientific research fund of Shanghai health bureau [Grant Number 20124168]. The manuscript content is the sole responsibility of the authors and does not necessarily represent the official views of Shanghai health bureau.

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Authors and Affiliations

  1. Department of Radiology, **nhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China

    Beiwu Tu, Lengwei Yu, Huimin Li & Dengbin Wang

  2. Department of Pediatric Urology, **nhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China

    Jianye Jia

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Contributions

BWT carried out the studies, participated in collecting data, and drafted the manuscript. JYJ and LWY performed the statistical analysis and participated in its design. HML and DBW helped to draft the manuscript. All authors read and approved the final manuscript.

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Correspondence to Beiwu Tu.

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Written informed consent was obtained from each participant.

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The present study was approved by the ethics committee of **nhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai. The requirement for informed consent was waived for this retrospective study.

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Supplementary Information

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261_2021_3162_MOESM1_ESM.tif

Supplementary material 1 (TIFF 322 kb) Supplementary Figure 1: Parameter acquisition. Ratio, Ratio of 80 kVp to 140 kVp; DEI, Dual Energy Index; Zeff, Effective atomic number.

Supplementary material 2 (TIFF 128 kb) Supplementary Figure 2: Study flowchart.

261_2021_3162_MOESM3_ESM.tif

Supplementary material 3 (TIFF 171 kb) Supplementary Figure 3: Correlations of various parameters with first ESWL outcome. Attenuations at 140 kVp, 80 kVp, and 120 kVp were represented in Hounsfield unit (HU). The unit of DEI, DER, and Zeff was the measured value (MV). Values of DEI, DER, and Zeff were MV*1000, MV*100, and MV*10, respectively. SF, stone-free; RS, residual stone; Zeff, effective atomic number; DEI, dual-energy index; DER, CT number ratio in dual-energy.

261_2021_3162_MOESM4_ESM.tif

Supplementary material 4 (TIFF 879 kb) Supplementary Figure 4: Receiver operating characteristic (ROC) curves for evaluating parameter performances in predicting ESWL outcomes. Outcome=0 (SF) or 1 (RS). Attenuation values and DEI were significantly related to ESWL success (SF). SF, stone-free; RS, residual stone; ESWL, extracorporeal shock wave lithotripsy.

Supplementary material 5 (DOCX 16 kb)

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Tu, B., Jia, J., Yu, L. et al. Correlative investigation between routine clinical parameters of dual-energy computed tomography and the outcomes of extracorporeal shock wave lithotripsy in children with urolithiasis: a retrospective study. Abdom Radiol 46, 4881–4887 (2021). https://doi.org/10.1007/s00261-021-03162-0

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