This document summarizes three studies on imaging techniques for renal calculi:
1) A study on a new MRI contrast agent found it was successfully synthesized and showed potential as a contrast agent for bladder cancer detection with in vitro experiments.
2) A study found that contemporary CT radiation exposure for renal colic is only marginally higher than historic IVU techniques, with improved time to diagnosis.
3) A study found digital plain X-rays have good sensitivity for detecting calcium-based kidney stones larger than 5mm, especially in the upper urinary tract, but CT or ultrasound may still be needed for smaller or lower tract stones.
1. CONCLUSIONS: SPIO-R11 was synthesized successfully via
chemical methods whihout significant change on physicochem-
ical properties. It has the uptake properties of safety, high effi-
ciency and specificity in T24 bladder cancer cell. The in vitro
experiment indicated that SPIO-R11 may be an valuable MR
contrast agent for further in vivo animal experiment and diag-
nostic applications in human.
SOURCE OF FUNDING: None
MP25-11 COMPARISON OF HISTORIC VS CONTEM-
PORARY RADIATION DOSAGE IN RENAL COLIC
Dermot O’Kane1,2, T Manning2, E How2, J Quinn3, A Hawes3,
Neil Smith2, Nathan Lawrentschuk1, Damien Bolton1
1Austin Hospital Department of Urology, University
of Melbourne Department of Surgery (Australia)
2Department of Urology, Gold Coast University Hospital
(Australia)
3Faculty of Medicine, Griffith University (Australia)
INTRODUCTION AND OBJECTIVES: Serial CT scanning
for renal calculus disease remains contentious because of con-
cerns about increased radiation exposure above previous estab-
lished levels. We aimed to quantify contemporaneous radiation
exposure with that deliviered in the era of IVU.
METHODS: We searched our hospital database for all patients
who presented to the emergency department over a one month
period (March) in 1990 with a diagnosis of renal colic and
compared them with a contemporaneous series. The estimated
effective radiation dose exposure for each patient was calculated,
and correlated with size and location of calculi.
RESULTS: The average effective radiation dose per patient in the
1990 group, for initial diagnosis and subsequent follow-up, was
4.61–2.83mSv. The average follow-up time in this group was
37.29 days, with a range from 0–122.99 days. The average effective
radiation dose per patient in the 2013 group was 4.75–2.27mSv.
The average follow-up time in this group was 62.79 days, with a
range from 0–171.60 days. Data was also collected on patient length
of stay and time to diagnosis. In the 1990 group there was a mean
delay to definitive diagnosis which ranged from 0.93–1.92 days.
CONCLUSIONS: The estimated effective radiation exposure
dose to each patient currently is only marginally higher than in
the era of IVU, with improvements in length of hospital stay and
time to definitive diagnosis. Improvements in technology and
judicious use of CT scanning should continue to lead to reduced
radiation exposure in the future.
SOURCE OF FUNDING: None
MP25-12 CONTEMPORARY SENSITIVITY AND SPECIFI-
CITY OF DIGITAL PLAIN X RAY FOR IDENTIFICATION OF
VARIANT CALCIUM COMPOSITION URINARY CALCULI
Dermot O’Kane1,2, T Manning2, E Gow2, J Quinn3,
A Hawes3, Neil Smith2, Nathan Lawrentschuk1,
Damien Bolton1
1Austin Hospital Department of Urology, University
of Melbourne Department of Surgery (Australia)
2Urology Department Gold Coast University Hospital
(Australia)
3School of Medicine Griffith University (Australia)
INTRODUCTION AND OBJECTIVES: Radiological imag-
ing remains ubiquitous in the follow-up of patients with renal
tract calculi. Concern exists regarding radiation dosage with
serial CT scanning. We assessed whether newer digital imaging
technology improved the utility of plain X Rays in determining
the size and location of calcium based urinary calculi.
METHODS: Laboratory databases across two urology centres
were audited, for calculi containing > 85% calcium oxalate or
> 85% calcium hydrogen phosphate. We identified 113 calculi
(91 calcium oxalate, 22 calcium hydrogen phosphate). Digital
imaging for each of these patients was obtained through hospital
radiology systems and analysed to determine whether CT iden-
tified calculi were visible on X-ray KUB.
RESULTS: The average calculus seen on X-ray was 8.43+ / -
4.99mm, and the average calculus not seen on X-ray even when
CT imaging was available was 5.39 + / - 3.20mm as measured on
CT (p < 0.001). 74.3% of all calculi were visible of digital X-ray.
X-ray was found to be 83.1% sensitive for calculi > 5 mm. 50% of
stones < 5 mm were not seen on X- ray. Statistical significance
was noted for the relationship between visibility and position in
the renal pelvis and proximal ureter (82%). 50% of mid-ureteric
calculi and 75% of distal ureteric calculi were visible.
CONCLUSIONS: Digital X-ray KUB is sensitive for calcium
salts calculi > 5 mm especially in the upper renal tract. Sensi-
tivity for other calculi may be below best practice standards. This
would suggest that CT or ultrasound as an adjunct to plain X- ray
for accurate follow-up may be required in many instances despite
radiation dosage.
SOURCE OF FUNDING: None
MP25-13 MRI AND US COMBINED STEREOTASSIC PRO-
STATIC BIOPSY: OUR PRELIMINARY EXPERIENCE
Rani Matteo1, Martorana Eugenio1, Territo Angelo1,
Galli Riccardo1, Paterlini Maurizio1, Micali Salvatore1,
Bianchi Giampaolo1
1University of Modena and Reggio Emilia (Italy)
INTRODUCTION AND OBJECTIVES: Explain our experi-
ence with stereotassic prostatic biopsy by fusion of MRI (Mag-
netic Risonance Imaging)/US (Ultra Sounds) immagines in real
time (BiopSeeÒ, Tema Sinergie, Germany).
METHODS: From December 2013 to Febbraury 2014, 9
‘‘prostate cancer (PCa) high risk patients’’ were processed to
trans-perineal stereotassic prostatic biopsy. All patients had a
previous prostatic mapping, negative for PCa. The average age
was 68 years (range 59 – 71 years), the average prostate volume
was 74 ml (ragne 50 – 106 ml) and the average PSA amounted to
7,5 ng/ml (range 2,4 – 14 ng/ml). 6 patientes had suspected me-
thastasys by previous MRI analisys. These information were
integrated by BiopSee System with data obtained by a biplanar
TRUS trasducer on a stepper. As results, prostatic MRI sospi-
ciuos lesions were merged, in real time, with TRUS images.
Then a transperineal saturation biopsy was done (32 samples);
sospiciuos MRI areas were included. Every target was recorded
by the software.
RESULTS: PCa diagnosis in 6/9 patients (detection rate = 67%).
Positive correlation between MRI sospicious lesion and histolog-
ical results in 4/6 patients (67% of patients). Patients with no
sospicious MRI areas, underwent to saturation biopsy, had 8,3% of
samples affected by PCa (5/60 samples). Only 1 patients reported a
post-operatory bleeding, spontaneously concluded. No patients
with urinary tract infections and/or urinary acute retention.
CONCLUSIONS: Our preliminary experience with stereotassic
biopsy reveals itself as a safe procedure, easy to use with high
-A234- MP25 ENDOUROLOGY: IMAGING 2