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Technical aspects to maximize the hyperaccuracy three-dimensional (HA3D™) computed tomography reconstruction for kidney stones surgery: a pilot study
Ist Teil von
Urolithiasis, 2021-12, Vol.49 (6), p.559-566
Ort / Verlag
Berlin/Heidelberg: Springer Berlin Heidelberg
Erscheinungsjahr
2021
Quelle
MEDLINE
Beschreibungen/Notizen
The aim of the current prospective pilot study was to describe a hyperaccuracy three-dimensional (HA3D
™
) model reconstruction technique, specifically developed to maximize the visualization of the renal collecting system’s anatomy, and its relationship with the stones, vessels and renal parenchyma, and to compare the HA3D
™
virtual models with the intraoperative findings. The image acquisition was performed using a CT scanner (Toshiba, Aquilion Prime) and included the unenhanced, arterial, venous and excretory phases. The DICOM format CT images were processed by MEDICS Srl (
www.medics3d.com
, Turin, Italy). In total, study included three patients with renal stone scheduled for non-papillary prone percutaneous nephrolithotomy (PCNL). The median age and BMI were 51 (range 49–54) and 25.5 (range 25.0–32.7), respectively. The median stone size was 1170 mm
2
(range 830–1520) and median stone density was 1130 HU (range 600–1340). In all cases, the quality of the CT images acquired with our protocol was adequate to perform the HA3D
™
reconstruction. Median operative and puncture time were 39.4 (range 35.2–44.0) and 1.9 (range 1.8–2.1) mins, respectively. The success rate for the first attempt of the percutaneous puncture was 100%, and only one PCNL tract was sufficient to complete the surgery. All three patients were stone-free on the third postoperative day. A dedicated imaging acquisition protocol and a tailored 3D model reconstruction process specifically developed for kidney stones treatment allow obtaining HA3D
™
highly relevant models to greatly match intraoperative findings during PCNL with the potential of minimizing bleeding and organ injury complications.