Quantification of asymptomatic kidney stone burden by computed tomography for predicting future symptomatic stone events

Michael G. Selby, Terri J. Vrtiska, Amy Krambeck, Cynthia H. McCollough, Hisham E. Elsherbiny, Eric J. Bergstralh, John C. Lieske, Andrew D. Rule

Research output: Contribution to journalArticle

15 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)45-50
Number of pages6
JournalUrology
Volume85
Issue number1
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Fingerprint

Kidney Calculi
Tomography
Medical Records

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

Cite this

Selby, M. G., Vrtiska, T. J., Krambeck, A., McCollough, C. H., Elsherbiny, H. E., Bergstralh, E. J., ... Rule, A. D. (2015). Quantification of asymptomatic kidney stone burden by computed tomography for predicting future symptomatic stone events. Urology, 85(1), 45-50. https://doi.org/10.1016/j.urology.2014.08.031

Quantification of asymptomatic kidney stone burden by computed tomography for predicting future symptomatic stone events. / Selby, Michael G.; Vrtiska, Terri J.; Krambeck, Amy; McCollough, Cynthia H.; Elsherbiny, Hisham E.; Bergstralh, Eric J.; Lieske, John C.; Rule, Andrew D.

In: Urology, Vol. 85, No. 1, 01.01.2015, p. 45-50.

Research output: Contribution to journalArticle

Selby, MG, Vrtiska, TJ, Krambeck, A, McCollough, CH, Elsherbiny, HE, Bergstralh, EJ, Lieske, JC & Rule, AD 2015, 'Quantification of asymptomatic kidney stone burden by computed tomography for predicting future symptomatic stone events', Urology, vol. 85, no. 1, pp. 45-50. https://doi.org/10.1016/j.urology.2014.08.031
Selby, Michael G. ; Vrtiska, Terri J. ; Krambeck, Amy ; McCollough, Cynthia H. ; Elsherbiny, Hisham E. ; Bergstralh, Eric J. ; Lieske, John C. ; Rule, Andrew D. / Quantification of asymptomatic kidney stone burden by computed tomography for predicting future symptomatic stone events. In: Urology. 2015 ; Vol. 85, No. 1. pp. 45-50.
@article{fcfe91ec2d6849318117fb61f5307251,
title = "Quantification of asymptomatic kidney stone burden by computed tomography for predicting future symptomatic stone events",
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.",
author = "Selby, {Michael G.} and Vrtiska, {Terri J.} and Amy Krambeck and McCollough, {Cynthia H.} and Elsherbiny, {Hisham E.} and Bergstralh, {Eric J.} and Lieske, {John C.} and Rule, {Andrew D.}",
year = "2015",
month = "1",
day = "1",
doi = "10.1016/j.urology.2014.08.031",
language = "English (US)",
volume = "85",
pages = "45--50",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Quantification of asymptomatic kidney stone burden by computed tomography for predicting future symptomatic stone events

AU - Selby, Michael G.

AU - Vrtiska, Terri J.

AU - Krambeck, Amy

AU - McCollough, Cynthia H.

AU - Elsherbiny, Hisham E.

AU - Bergstralh, Eric J.

AU - Lieske, John C.

AU - Rule, Andrew D.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84918783261&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84918783261&partnerID=8YFLogxK

U2 - 10.1016/j.urology.2014.08.031

DO - 10.1016/j.urology.2014.08.031

M3 - Article

C2 - 25440821

AN - SCOPUS:84918783261

VL - 85

SP - 45

EP - 50

JO - Urology

JF - Urology

SN - 0090-4295

IS - 1

ER -