Advanced non-contrasted computed tomography post-processing by CT-Calculometry (CT-CM) outperforms established...

Area of Science:

• Urology
• Medical Imaging
• Nephrology

Background:

• Shock wave lithotripsy (SWL) is a primary treatment for urinary calculi.
• Predicting SWL success is crucial for patient management and resource allocation.
• Established predictors of SWL success have limitations in accuracy.

Purpose of the Study:

• To assess the predictive capability of novel CT-calculometry (CT-CM) parameters derived from non-contrasted computed tomography (NCCT) for SWL success.
• To compare CT-CM parameters against traditional predictors of SWL outcomes.

Main Methods:

• Retrospective analysis of 312 patients with upper tract urinary calculi undergoing SWL.
• NCCT data was post-processed using CT-CM to analyze stone size, shape, 3-D greyscale, and homogeneity (skewness, kurtosis).
• Established predictors (skin-to-stone distance, BMI, stone diameter, mean attenuation) were compared using logistic regression and ROC statistics.

Main Results:

• The overall SWL success rate was 59%.
• CT-CM parameters, including stone volume, surface area, mean 3D attenuation, skewness, and kurtosis, outperformed established predictors.
• CT-CM enabled a fivefold increase in patients for whom SWL outcome could be predicted with 80% accuracy.

Conclusions:

• Advanced NCCT post-processing with CT-CM provides novel parameters that surpass traditional predictors for SWL response.
• Integrating CT-CM into clinical practice holds potential to decrease SWL failure rates.