Medullary Sponge Kidney vs. Idiopathic Urolithiasis: Stone Growth Detection "Presentation" - Mariah Hernandez
August 15, 2024
At the World Congress of Endourology and Uro-Technology, Mariah Hernandez presents a study examining the accuracy of CT reports in assessing stone burden stability in patients with medullary sponge kidney (MSK) and idiopathic urolithiasis. The research uses 3D Slicer software to measure volumetric stone burdens in 70 patients with reportedly stable CT scans. She concludes that volumetric assessment demonstrates that CT reports of stable stone disease miss significant stone growth in nearly half of MSK patients and almost a quarter of idiopathic urolithiasis patients.
Biographies:
Mariah Hernandez, Research Specialist, Department of Urology, University of California, Irvine, CA
Biographies:
Mariah Hernandez, Research Specialist, Department of Urology, University of California, Irvine, CA
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Read the Full Video Transcript
Mariah Hernandez: My name is Mariah, and I'm a current research specialist at the University of California, Irvine, Department of Urology. Today I'm presenting a project titled "Stable Stone Burden": Truth or Myth? Assessing Alterations in Volumetric Stone Burden Among Patients With Medullary Sponge Kidney. Medullary sponge kidney patients exhibit numerous renal calcifications, posing a formidable challenge in monitoring urolithiasis progression. While accurate linear stone assessments are hindered by time constraints and high interobserver variability, automated stone volume measurements are now emerging as an effective and reliable approach to more accurately assess overall stone burden.
As such, we sought to assess the accuracy of annual non-contrast CT reports of stable stone burden among medullary sponge kidney patients versus urolithiasis patients without an underlying renal disorder. A retrospective review was conducted from 2018 to 2023. Seventy urolithiasis patients with either stable or unchanged CT reports were included. Twenty patients had medullary sponge kidney disease, and fifty had no underlying renal disorder. 3D Slicer was used to determine volumetric stone burdens of two CT scans a year or more apart in all seventy patients. Among all patients with a stable or unchanged report, the error rate based on volumetric determination was defined as failure to detect a 15% or more increase in stone volume.
In the medullary sponge kidney group, a stone burden increase of 15%, 25%, and 50% was missed in 49%, 38%, and 21% of cases, respectively. In the idiopathic stone group, the stone burden increase of 15%, 25%, and 50% was missed in 24%, 9%, and 7% of cases, respectively. Of note, a diagnosis of medullary sponge kidney was associated with an incorrect assessment of unchanged stone burden for all three growth thresholds.
In conclusion, a volumetric assessment of stone burden reveals that a CT report of stable stone disease misses significant stone growth in nearly one-half of medullary sponge kidney patients, and in almost a fourth of idiopathic urolithiasis patients. Thank you.
Mariah Hernandez: My name is Mariah, and I'm a current research specialist at the University of California, Irvine, Department of Urology. Today I'm presenting a project titled "Stable Stone Burden": Truth or Myth? Assessing Alterations in Volumetric Stone Burden Among Patients With Medullary Sponge Kidney. Medullary sponge kidney patients exhibit numerous renal calcifications, posing a formidable challenge in monitoring urolithiasis progression. While accurate linear stone assessments are hindered by time constraints and high interobserver variability, automated stone volume measurements are now emerging as an effective and reliable approach to more accurately assess overall stone burden.
As such, we sought to assess the accuracy of annual non-contrast CT reports of stable stone burden among medullary sponge kidney patients versus urolithiasis patients without an underlying renal disorder. A retrospective review was conducted from 2018 to 2023. Seventy urolithiasis patients with either stable or unchanged CT reports were included. Twenty patients had medullary sponge kidney disease, and fifty had no underlying renal disorder. 3D Slicer was used to determine volumetric stone burdens of two CT scans a year or more apart in all seventy patients. Among all patients with a stable or unchanged report, the error rate based on volumetric determination was defined as failure to detect a 15% or more increase in stone volume.
In the medullary sponge kidney group, a stone burden increase of 15%, 25%, and 50% was missed in 49%, 38%, and 21% of cases, respectively. In the idiopathic stone group, the stone burden increase of 15%, 25%, and 50% was missed in 24%, 9%, and 7% of cases, respectively. Of note, a diagnosis of medullary sponge kidney was associated with an incorrect assessment of unchanged stone burden for all three growth thresholds.
In conclusion, a volumetric assessment of stone burden reveals that a CT report of stable stone disease misses significant stone growth in nearly one-half of medullary sponge kidney patients, and in almost a fourth of idiopathic urolithiasis patients. Thank you.