They found on univariate analysis that stone size, stone volume, ureteral HU distal to the stone, and the degree of hydronephrosis were significantly greater for those with stone impaction. Upon multivariate analysis, the only factor that remained significant was the ureteral HU distal to the stone. They followed this with a sensitivity analysis which determined that a cutoff value of 27 HU accurately distinguished between impacted and non-impacted stones (sensitivity, specificity, and PPV of 85%).
These findings seem promising in that a stone may potentially be identified as impacted, and thus can particularly benefit surgeons by providing them the insight to alter operative plans and preoperative management (e.g. withholding anti-platelet therapy). Dr. Parkhomenko notes that they plan to conduct a validation study using the 27 HU cutoff to prospectively predict impacted ureteral stones.
Speaker: Egor Parkhomenko
Written By: Shoaib Safiullah, MS4 for UroToday.com
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA