De additonele waarde van Dual Energy CT voor de behandeling van Urolithiasis middels ESWL

Kerver, N. (Nienke) (2017) De additonele waarde van Dual Energy CT voor de behandeling van Urolithiasis middels ESWL. thesis, Medicine.

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Abstract

Aim: the aim of this study is to determine the additional value of Dual Energy Computer Tomography (DECT) for the treatment of urolithiasis with extracorporeal shock wave lithotripsy (ESWL). Methods: 299 patients were treated with ESWL and had a chemical stone analysis available between January 2006 and December 2016 (cohort 1). DECT and chemical stone analyses were available of 37 patients between May 2016 and April 2017 (cohort 2). First, the predictors for success of ESWL were determined (cohort 1). Analyses were done with binary logistic regression. Succes of ESWL was defined as total stone clearance on imaging in patients without an additional treatment within three months of the last ESWL-session. Hence, in the second part of the research the distinctive ability of DECT for uric acid and unsuitable compositions for ESWL, according to the earlier part of the study, was determined (cohort 2). The Dual Energy ratio (DE-ratio) was compared with Mann-Withney U tests between these groups. Results: calcium oxalate monohydrate (COM) was a significant negative predictor for success of ESWL (p=0.03). Other significant predictors were the stone diameter, location of the stone (lower calyx versus elsewhere) and the number of stones (one versus multiple). DECT was able to differentiate uric acid stones from other compositions (sensitivity: 100%; specificity: 94%). However, COM stones could not be differentiated. Conclusion: DECT has an additional vaue for the indication of ESWL, especially concerning uric acid stones. Further research is necessary to improve the insights about DECT.

Item Type:	Thesis (Thesis)
Supervisor name:	Facultair begeleider: and Roemeling, S. and Afdeling: urologie
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:40
Last Modified:	25 Jun 2020 10:40
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/194

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