title: Internal Structure of Kidney Calculi as a Predictor for Shockwave Lithotripsy Success.
abstract: BACKGROUND
  The internal structure of renal calculi can be determined on CT using bone windows and may be classified as homogeneous or inhomogeneous with void regions. In vitro studies have shown homogeneous stones to be less responsive to extracorporeal shockwave lithotripsy (SWL). The objective was to evaluate whether the internal morphology of calculi defined by CT bone window influences SWL outcome in vivo.
  
  
  METHODS
  One hundred eleven patients with solitary renal calculi treated with SWL were included. Treatment data were registered prospectively and follow-up data were collected retrospectively. All patients had noncontrast computed tomography (NCCT) performed before SWL and at 3-month follow-up. The stones were categorized as homogeneous or inhomogeneous. At follow-up, the patient's stone status was registered. Stone-free status was defined as no evidence of calculi on NCCT. Treatment was considered successful if the patient was either stone free or had clinically insignificant residual fragments.
  
  
  RESULTS
  Using simple logistic regression, the odds for being stone free 3 months post-SWL were significantly reduced in the patients with inhomogeneous stones compared with patients with homogeneous stones (odds ratio 0.43 [95% confidence interval 0.20, 0.92; p < 0.05]). However, when adjusting for stone size by multiple logistic regression, including stone size (area) as a covariate, this difference became insignificant.
  
  
  CONCLUSIONS
  The internal structure of kidney stones did not predict the outcome of SWL in vivo.
authors.affiliation: Department of Urology, Urological Research Center, Lillebaelt Hospital, University of Southern Denmark , Fredericia, Denmark .
authors.forename: Frederikke Eichner
authors.initials: FE
authors.lastname: Christiansen
authors.affiliation: Department of Urology, Urological Research Center, Lillebaelt Hospital, University of Southern Denmark , Fredericia, Denmark .
authors.forename: Kim Hovgaard
authors.initials: KH
authors.lastname: Andreassen
authors.affiliation: Department of Urology, Urological Research Center, Lillebaelt Hospital, University of Southern Denmark , Fredericia, Denmark .
authors.forename: Susanne Sloth
authors.initials: SS
authors.lastname: Osther
authors.affiliation: Department of Urology, Urological Research Center, Lillebaelt Hospital, University of Southern Denmark , Fredericia, Denmark .
authors.forename: Palle Joern Sloth
authors.initials: PJ
authors.lastname: Osther
mesh_terms: D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome