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Intraoperative cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy: a feasibility study

Cone beam computed tomography (CBCT) provides multiplanar cross-sectional imaging and three-dimensional reconstructions and can be used intraoperatively in a hybrid operating room. In this study, we investigated the feasibility of using a CBCT-scanner for detecting residual stones during percutaneou...

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Autores principales: Kingma, R. A., Voskamp, M. J. H., Doornweerd, B. H. J., de Jong, I. J., Roemeling, S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560674/
https://www.ncbi.nlm.nih.gov/pubmed/33683420
http://dx.doi.org/10.1007/s00240-021-01259-1
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author Kingma, R. A.
Voskamp, M. J. H.
Doornweerd, B. H. J.
de Jong, I. J.
Roemeling, S.
author_facet Kingma, R. A.
Voskamp, M. J. H.
Doornweerd, B. H. J.
de Jong, I. J.
Roemeling, S.
author_sort Kingma, R. A.
collection PubMed
description Cone beam computed tomography (CBCT) provides multiplanar cross-sectional imaging and three-dimensional reconstructions and can be used intraoperatively in a hybrid operating room. In this study, we investigated the feasibility of using a CBCT-scanner for detecting residual stones during percutaneous nephrolithotomy (PCNL). Intraoperative CBCT-scans were made during PCNL procedures from November 2018 until March 2019 in a university hospital. At the point where the urologist would have otherwise ended the procedure, a CBCT-scan was made to image any residual fragments that could not be detected by either nephroscopy or conventional C-arm fluoroscopy. Residual fragments that were visualized on the CBCT-scan were attempted to be extracted additionally. To evaluate the effect of this additional extraction, each CBCT-scan was compared with a regular follow-up CT-scan that was made 4 weeks postoperatively. A total of 19 procedures were analyzed in this study. The mean duration of performing the CBCT-scan, including preparation and interpretation, was 8 min. Additional stone extraction, if applicable, had a mean duration of 11 min. The mean effective dose per CBCT-scan was 7.25 mSv. Additional extraction of residual fragments as imaged on the CBCT-scan occurred in nine procedures (47%). Of the follow-up CT-scans, 63% showed a stone-free status as compared to 47% of the intraoperative CBCT-scans. We conclude that the use of CBCT for the detection of residual stones in PCNL is meaningful, safe, and feasible.
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spelling pubmed-85606742021-11-15 Intraoperative cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy: a feasibility study Kingma, R. A. Voskamp, M. J. H. Doornweerd, B. H. J. de Jong, I. J. Roemeling, S. Urolithiasis Original Paper Cone beam computed tomography (CBCT) provides multiplanar cross-sectional imaging and three-dimensional reconstructions and can be used intraoperatively in a hybrid operating room. In this study, we investigated the feasibility of using a CBCT-scanner for detecting residual stones during percutaneous nephrolithotomy (PCNL). Intraoperative CBCT-scans were made during PCNL procedures from November 2018 until March 2019 in a university hospital. At the point where the urologist would have otherwise ended the procedure, a CBCT-scan was made to image any residual fragments that could not be detected by either nephroscopy or conventional C-arm fluoroscopy. Residual fragments that were visualized on the CBCT-scan were attempted to be extracted additionally. To evaluate the effect of this additional extraction, each CBCT-scan was compared with a regular follow-up CT-scan that was made 4 weeks postoperatively. A total of 19 procedures were analyzed in this study. The mean duration of performing the CBCT-scan, including preparation and interpretation, was 8 min. Additional stone extraction, if applicable, had a mean duration of 11 min. The mean effective dose per CBCT-scan was 7.25 mSv. Additional extraction of residual fragments as imaged on the CBCT-scan occurred in nine procedures (47%). Of the follow-up CT-scans, 63% showed a stone-free status as compared to 47% of the intraoperative CBCT-scans. We conclude that the use of CBCT for the detection of residual stones in PCNL is meaningful, safe, and feasible. Springer Berlin Heidelberg 2021-03-08 2021 /pmc/articles/PMC8560674/ /pubmed/33683420 http://dx.doi.org/10.1007/s00240-021-01259-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Paper
Kingma, R. A.
Voskamp, M. J. H.
Doornweerd, B. H. J.
de Jong, I. J.
Roemeling, S.
Intraoperative cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy: a feasibility study
title Intraoperative cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy: a feasibility study
title_full Intraoperative cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy: a feasibility study
title_fullStr Intraoperative cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy: a feasibility study
title_full_unstemmed Intraoperative cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy: a feasibility study
title_short Intraoperative cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy: a feasibility study
title_sort intraoperative cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy: a feasibility study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560674/
https://www.ncbi.nlm.nih.gov/pubmed/33683420
http://dx.doi.org/10.1007/s00240-021-01259-1
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