Technical aspects to maximize the hyperaccuracy three-dimensional (HA3D™) computed tomography reconstruction for kidney stones surgery: a pilot study

• Published in: Urolithiasis Vol. 49; no. 6; pp. 559 - 566
• Main Authors: Tsaturyan, Arman, Bellin, Andrea, Barbuto, Simona, Zampakis, Peter, Ntzanis, Epameinondas, Lattarulo, Marco, Kalogeropoulou, Christina, Liatsikos, Evangelos, Kallidonis, Panagiotis
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2021; Springer Nature B.V
• Subjects: Hospitals; Humans; Iodine; Kidney; Kidney Calculi - diagnostic imaging; Kidney Calculi - surgery; Kidney stones; Kidneys; Medical Biochemistry; Medicine; Medicine & Public Health; Nephrolithotomy, Percutaneous - adverse effects; Nephrology; Nephrostomy, Percutaneous; Original Paper; Patients; Pilot Projects; Surgery; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonic imaging; Urinary tract diseases; Urology; Visualization; Hyperaccuracy 3D reconstruction; Standard PCNL; Non-papillary puncture; Mini-PCNL; Kidney stone
• ISSN: 2194-7228; 2194-7236
• DOI: 10.1007/s00240-021-01262-6

The aim of the current prospective pilot study was to describe a hyperaccuracy three-dimensional (HA3D ™ ) model reconstruction technique, specifically developed to maximize the visualization of the renal collecting system’s anatomy, and its relationship with the stones, vessels and renal parenchyma, and to compare the HA3D ™ virtual models with the intraoperative findings. The image acquisition was performed using a CT scanner (Toshiba, Aquilion Prime) and included the unenhanced, arterial, venous and excretory phases. The DICOM format CT images were processed by MEDICS Srl ( www.medics3d.com , Turin, Italy). In total, study included three patients with renal stone scheduled for non-papillary prone percutaneous nephrolithotomy (PCNL). The median age and BMI were 51 (range 49–54) and 25.5 (range 25.0–32.7), respectively. The median stone size was 1170 mm 2 (range 830–1520) and median stone density was 1130 HU (range 600–1340). In all cases, the quality of the CT images acquired with our protocol was adequate to perform the HA3D ™ reconstruction. Median operative and puncture time were 39.4 (range 35.2–44.0) and 1.9 (range 1.8–2.1) mins, respectively. The success rate for the first attempt of the percutaneous puncture was 100%, and only one PCNL tract was sufficient to complete the surgery. All three patients were stone-free on the third postoperative day. A dedicated imaging acquisition protocol and a tailored 3D model reconstruction process specifically developed for kidney stones treatment allow obtaining HA3D ™ highly relevant models to greatly match intraoperative findings during PCNL with the potential of minimizing bleeding and organ injury complications.