Quantification of Asymptomatic Kidney Stone Burden by Computed Tomography for Predicting Future Symptomatic Stone Events
Objective To find the optimal characterization of asymptomatic radiographic stone burden on computed tomography (CT) scans. Methods A survey was sent to stone formers who underwent a CT scan while asymptomatic during a stone clinic evaluation. Symptomatic stone passage events after CT scan were dete...
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| Published in | Urology (Ridgewood, N.J.) Vol. 85; no. 1; pp. 45 - 50 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
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Elsevier Inc
01.01.2015
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| Abstract | Objective To find the optimal characterization of asymptomatic radiographic stone burden on computed tomography (CT) scans. Methods A survey was sent to stone formers who underwent a CT scan while asymptomatic during a stone clinic evaluation. Symptomatic stone passage events after CT scan were detected by survey and medical record review. Radiographic stone burden was quantified by number of stones, largest stone diameter, automated total stone volume (TSV), and bilateral stones and then compared as predictors of stone events. Results There were 550 stone formers; 43% had a stone event for a median of 4.7 years after the CT scan. Stone burden by quartiles was 0-1, 2-3, 4-6, and ≥7 for number of stones; 0-2, 3-4, 5-7, and ≥8 mm for largest stone diameter; and 0-8, 9-78, 79-280, and ≥281 mm3 for TSV; 48% had bilateral stones. The hazard ratios (HRs) for symptomatic event was 1.30 ( P <.001) for the number of stones per quartile, 1.26 ( P <.001) for largest stone diameter per quartile, 1.38 ( P <.001) for TSV per quartile, and 1.80 ( P <.001) for bilateral stones. On multivariate analysis, only TSV was an independent predictor of symptomatic events (HR, 1.35 per quartile; P = .01). This risk of events with TSV was also independent of demographics, urine chemistries, and stone composition. Among the 53 patients with interim events between CT scans, a rapid increase in TSV between CT scans (>570 mm3 per year) predicted subsequent events (HR, 2.8; P = .05). Conclusion Automated TSV is more predictive of symptomatic events than manual methods for quantifying stone burden on CT scan. |
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| AbstractList | To find the optimal characterization of asymptomatic radiographic stone burden on computed tomography (CT) scans.
A survey was sent to stone formers who underwent a CT scan while asymptomatic during a stone clinic evaluation. Symptomatic stone passage events after CT scan were detected by survey and medical record review. Radiographic stone burden was quantified by number of stones, largest stone diameter, automated total stone volume (TSV), and bilateral stones and then compared as predictors of stone events.
There were 550 stone formers; 43% had a stone event for a median of 4.7 years after the CT scan. Stone burden by quartiles was 0-1, 2-3, 4-6, and ≥7 for number of stones; 0-2, 3-4, 5-7, and ≥8 mm for largest stone diameter; and 0-8, 9-78, 79-280, and ≥281 mm3 for TSV; 48% had bilateral stones. The hazard ratios (HRs) for symptomatic event was 1.30 (P <.001) for the number of stones per quartile, 1.26 (P <.001) for largest stone diameter per quartile, 1.38 (P <.001) for TSV per quartile, and 1.80 (P <.001) for bilateral stones. On multivariate analysis, only TSV was an independent predictor of symptomatic events (HR, 1.35 per quartile; P = .01). This risk of events with TSV was also independent of demographics, urine chemistries, and stone composition. Among the 53 patients with interim events between CT scans, a rapid increase in TSV between CT scans (>570 mm3 per year) predicted subsequent events (HR, 2.8; P = .05).
Automated TSV is more predictive of symptomatic events than manual methods for quantifying stone burden on CT scan. Objective To find the optimal characterization of asymptomatic radiographic stone burden on computed tomography (CT) scans. Methods A survey was sent to stone formers who underwent a CT scan while asymptomatic during a stone clinic evaluation. Symptomatic stone passage events after CT scan were detected by survey and medical record review. Radiographic stone burden was quantified by number of stones, largest stone diameter, automated total stone volume (TSV), and bilateral stones and then compared as predictors of stone events. Results There were 550 stone formers; 43% had a stone event for a median of 4.7 years after the CT scan. Stone burden by quartiles was 0-1, 2-3, 4-6, and ≥7 for number of stones; 0-2, 3-4, 5-7, and ≥8 mm for largest stone diameter; and 0-8, 9-78, 79-280, and ≥281 mm3 for TSV; 48% had bilateral stones. The hazard ratios (HRs) for symptomatic event was 1.30 ( P <.001) for the number of stones per quartile, 1.26 ( P <.001) for largest stone diameter per quartile, 1.38 ( P <.001) for TSV per quartile, and 1.80 ( P <.001) for bilateral stones. On multivariate analysis, only TSV was an independent predictor of symptomatic events (HR, 1.35 per quartile; P = .01). This risk of events with TSV was also independent of demographics, urine chemistries, and stone composition. Among the 53 patients with interim events between CT scans, a rapid increase in TSV between CT scans (>570 mm3 per year) predicted subsequent events (HR, 2.8; P = .05). Conclusion Automated TSV is more predictive of symptomatic events than manual methods for quantifying stone burden on CT scan. OBJECTIVETo find the optimal characterization of asymptomatic radiographic stone burden on computed tomography (CT) scans.METHODSA survey was sent to stone formers who underwent a CT scan while asymptomatic during a stone clinic evaluation. Symptomatic stone passage events after CT scan were detected by survey and medical record review. Radiographic stone burden was quantified by number of stones, largest stone diameter, automated total stone volume (TSV), and bilateral stones and then compared as predictors of stone events.RESULTSThere were 550 stone formers; 43% had a stone event for a median of 4.7 years after the CT scan. Stone burden by quartiles was 0-1, 2-3, 4-6, and ≥7 for number of stones; 0-2, 3-4, 5-7, and ≥8 mm for largest stone diameter; and 0-8, 9-78, 79-280, and ≥281 mm(3) for TSV; 48% had bilateral stones. The hazard ratios (HRs) for symptomatic event was 1.30 (P <.001) for the number of stones per quartile, 1.26 (P <.001) for largest stone diameter per quartile, 1.38 (P <.001) for TSV per quartile, and 1.80 (P <.001) for bilateral stones. On multivariate analysis, only TSV was an independent predictor of symptomatic events (HR, 1.35 per quartile; P = .01). This risk of events with TSV was also independent of demographics, urine chemistries, and stone composition. Among the 53 patients with interim events between CT scans, a rapid increase in TSV between CT scans (>570 mm(3) per year) predicted subsequent events (HR, 2.8; P = .05).CONCLUSIONAutomated TSV is more predictive of symptomatic events than manual methods for quantifying stone burden on CT scan. To find the optimal characterization of asymptomatic radiographic stone burden on computed tomography (CT) scans. A survey was sent to stone formers who underwent a CT scan while asymptomatic during a stone clinic evaluation. Symptomatic stone passage events after CT scan were detected by survey and medical record review. Radiographic stone burden was quantified by number of stones, largest stone diameter, automated total stone volume (TSV), and bilateral stones and then compared as predictors of stone events. There were 550 stone formers; 43% had a stone event for a median of 4.7 years after the CT scan. Stone burden by quartiles was 0-1, 2-3, 4-6, and ≥7 for number of stones; 0-2, 3-4, 5-7, and ≥8 mm for largest stone diameter; and 0-8, 9-78, 79-280, and ≥281 mm(3) for TSV; 48% had bilateral stones. The hazard ratios (HRs) for symptomatic event was 1.30 (P <.001) for the number of stones per quartile, 1.26 (P <.001) for largest stone diameter per quartile, 1.38 (P <.001) for TSV per quartile, and 1.80 (P <.001) for bilateral stones. On multivariate analysis, only TSV was an independent predictor of symptomatic events (HR, 1.35 per quartile; P = .01). This risk of events with TSV was also independent of demographics, urine chemistries, and stone composition. Among the 53 patients with interim events between CT scans, a rapid increase in TSV between CT scans (>570 mm(3) per year) predicted subsequent events (HR, 2.8; P = .05). Automated TSV is more predictive of symptomatic events than manual methods for quantifying stone burden on CT scan. |
| Author | Vrtiska, Terri J Bergstralh, Eric J Krambeck, Amy E Elsherbiny, Hisham E Selby, Michael G McCollough, Cynthia H Rule, Andrew D Lieske, John C |
| AuthorAffiliation | 3 Department of Urology, Mayo Clinic, Rochester, MN 4 Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 5 Division of Epidemiology, Mayo Clinic, Rochester, MN 1 Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 2 Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN |
| AuthorAffiliation_xml | – name: 3 Department of Urology, Mayo Clinic, Rochester, MN – name: 2 Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN – name: 1 Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN – name: 4 Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN – name: 5 Division of Epidemiology, Mayo Clinic, Rochester, MN |
| Author_xml | – sequence: 1 fullname: Selby, Michael G – sequence: 2 fullname: Vrtiska, Terri J – sequence: 3 fullname: Krambeck, Amy E – sequence: 4 fullname: McCollough, Cynthia H – sequence: 5 fullname: Elsherbiny, Hisham E – sequence: 6 fullname: Bergstralh, Eric J – sequence: 7 fullname: Lieske, John C – sequence: 8 fullname: Rule, Andrew D |
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| Snippet | Objective To find the optimal characterization of asymptomatic radiographic stone burden on computed tomography (CT) scans. Methods A survey was sent to stone... To find the optimal characterization of asymptomatic radiographic stone burden on computed tomography (CT) scans. A survey was sent to stone formers who... OBJECTIVETo find the optimal characterization of asymptomatic radiographic stone burden on computed tomography (CT) scans.METHODSA survey was sent to stone... |
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| SubjectTerms | Asymptomatic Diseases Female Humans Kidney Calculi - diagnostic imaging Male Middle Aged Prognosis Tomography, X-Ray Computed Urology |
| Title | Quantification of Asymptomatic Kidney Stone Burden by Computed Tomography for Predicting Future Symptomatic Stone Events |
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