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Comparing non contrast computerized tomography criteria versus dual X-ray absorptiometry as predictors of radio-opaque upper urinary tract stone fragmentation after electromagnetic shockwave lithotripsy

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Abstract

The objective of this study was to assess the value of dual X-ray absorptiometry (DXA) in comparison to non contrast computed tomography (NCCT) density as possible predictors of upper urinary tract stone disintegration by shock wave lithotripsy (SWL). This study included 100 consecutive patients, with solitary renal stone 0.5–2 cm or upper ureteral stone up to 1 cm. DXA to calculate stone mineral density (SMD) and stone mineral content (SMC) was done. NCCT was performed to measure Hounsfield units (HU). SWL was performed with an electromagnetic lithotripsy, plain X-ray documented disintegration after SWL. Successful treatment was defined as stone free or complete fragmentation after 1 or 2 sessions of SWL. The impact of patients age, sex, body mass index, stone laterality, location, volume, length, mean SMC and SMD, HU and Hounsfield density (HD), skin to stone distance (SSD) and number of shock waves were evaluated by univariate and multivariate analysis. Only 76 patients were available for follow-up. Success of disintegration was observed in 50 out of 76 patients (65.8 %). On multivariate analysis, SMC and number of shock wave were the significant independent factors affecting SWL outcome (p = 0.04 and p = 0.000, respectively). SMC as detected by DXA is a significant predictor of success of stone disintegration by SWL. SMC measured by DXA is more accurate than HU measured by CT. Patients with high stone mineral content (SMC greater than 0.65 g) should be directly offered another treatment option.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Urology Department, Assiut University Hospital, Assiut, Egypt

    Diaa A. Hameed, Mohammed A. Elgammal, Ehab O. ElGanainy, Ahmed Mohamed El-Taher & Abdelfatah Ibrahim Ahmed

  2. Sanaa University, Sanaa, Yemen

    Adel Hageb

  3. Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt

    Khaled Mohammed

  4. Radiology Department, Assiut University Hospital, Assiut, Egypt

    Mostafa Mohamed Mostafa

Authors
  1. Diaa A. Hameed
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  2. Mohammed A. Elgammal
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  3. Ehab O. ElGanainy
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  4. Adel Hageb
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  5. Khaled Mohammed
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  6. Ahmed Mohamed El-Taher
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  7. Mostafa Mohamed Mostafa
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  8. Abdelfatah Ibrahim Ahmed
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Correspondence to Mohammed A. Elgammal.

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Hameed, D.A., Elgammal, M.A., ElGanainy, E.O. et al. Comparing non contrast computerized tomography criteria versus dual X-ray absorptiometry as predictors of radio-opaque upper urinary tract stone fragmentation after electromagnetic shockwave lithotripsy. Urolithiasis 41, 511–515 (2013). https://doi.org/10.1007/s00240-013-0596-1

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  • DOI: https://doi.org/10.1007/s00240-013-0596-1

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