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Computed tomography in predicting gall stone solubility: a prospective trial.

A Caroli¹, G Del Favero, F Di Mario

¹Instituto di Medicina Interna, Università degli Studi di Padova, Italy.

|May 1, 1992

Summary

Computed tomography can predict gallstone dissolution success. Low-density gallstones (under 60 Hounsfield units) are more likely to dissolve with ursodeoxycholic acid therapy.

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Area of Science:

Radiology
Gastroenterology
Hepatology

Background:

Gallstone dissolution therapy aims to non-invasively treat symptomatic gallstones.
Predicting treatment success is crucial for patient selection and resource allocation.
Computed tomography (CT) offers quantitative stone assessment.

Purpose of the Study:

To investigate the correlation between gallstone density measured by CT and the success rate of oral litholytic therapy.
To determine if CT-assessed gallstone density can predict treatment outcomes.

Main Methods:

Prospective study of 28 patients undergoing oral litholytic therapy.
Gallstone density was measured using CT, with a threshold of 60 Hounsfield units (HU).
Patients were divided into low-density (<60 HU) and high-density (>60 HU) groups, treated with ursodeoxycholic acid for 12 months, and monitored via ultrasound.

Main Results:

Complete dissolution occurred in 50% of patients with low-density stones and 0% with high-density stones.
Partial dissolution was observed in 20% of low-density and 33% of high-density groups.
Significantly higher complete dissolution rates were seen in the low-density group (p < 0.02).

Conclusions:

CT-assessed gallstone density is a significant predictor of successful oral litholytic therapy.
Patients with lower gallstone density (<60 HU) have a better prognosis for complete stone dissolution.
CT imaging can aid in selecting appropriate candidates for bile acid therapy for gallstones.