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  3. 27.Role of Hounsfield Unit in Predicting the Outcome of Treatment of Renal Calculi with Extracorporeal Shock Wave Lithotripsy (ESWL)
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27.Role of Hounsfield Unit in Predicting the Outcome of Treatment of Renal Calculi with Extracorporeal Shock Wave Lithotripsy (ESWL)

Zeeshan Shaukat1, Abdul Rauf2, Fazal-ur-Rehman Khan2, Rana Atta ur Rehman3 Hammad Shafi4 and Muhammad Tayyab Naeem2

ABSTRACT

Objective: Objective of the study is to see the predictive accuracy of HU <934 in predicting the stone clearance in renal calculi with ESWL.

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted at the Urology Department at Shaikh Zayed Hospital, Lahore from October 2019 to April 2020.

Materials and Methods: This study was carried out in the Department of Urology. A written informed consent was taken from all the patients included in the study after discussing risk and benefit ratio. Patients with stone density of more than 934 HU were informed about the lower chances of stone removal. All the patients were diagnosed and followed on the same CT scan machine (Multi detector CT scanner; Light speed VCT; 140kv/3.91mm) and were given treatment on the same lithotripter (STORZ Medical MODULITH SLX; 4thGeneration). Post ESWL antibiotics were given for three days, with oral analgesics if required. Patients were followed after maximum 4 sessions of ESWL over a duration of three months.

Results: The mean age of patients was 44.54±9.16 years with minimum and maximum age as 18 and 60 years. There were 134(55.8%) male and 106(44.2%) female cases. There were 197(82.1%) cases who had stone clearance and 43(17.9%) cases did not have stone clearance. There were 187 cases who had density as <934 and had tone clearance and 35(81.4%) cases had density ≥934 and did not have stone clearance while there were 8(18.6%) false positive and 10(5.1%) cases had false negative. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of density <934 was 94.92%, 81.40%, 95.90%, 77.78% and 92.50% respectively.

Conclusion: HU can be used for multiple purposes as it not only identify tumor in the renal system also it could tell about the characteristics of urinary stone. CT scan is equally effective for the determination of the stone composition and also determination of the efficacy of ESWL for the stone clearance.

Key Words: ESWL, Renal Stone, Hounsfield Unit, Ureter, Bladder

Citation of article: Shaukat Z, Rauf A, Khan FR, RA Rehman, Shafi H, Naeem MT. Role of Hounsfield Unit in Predicting the Outcome of Treatment of Renal Calculi with Extracorporeal Shock Wave Lithotripsy (ESWL). Med Forum 2022;33(1):110-114.