title: Use of cone-beam CT and live 3-D needle guidance to facilitate percutaneous nephrostomy and nephrolithotripsy access in children and adolescents.
abstract: BACKGROUND
  Gaining access into non-dilated renal collecting systems for percutaneous nephrolithotripsy, particularly in patients with prohibitive body habitus and/or scoliosis, is often challenging using conventional techniques.
  
  
  OBJECTIVE
  To evaluate the feasibility of cone-beam CT for percutaneous nephrostomy placement for subsequent percutaneous nephrolithotripsy in children and adolescents.
  
  
  METHODS
  A retrospective review of percutaneous nephrostomy revealed use of cone-beam CT and 3-D guidance in 12 percutaneous nephrostomy procedures for 9 patients between 2006 and 2015. All cone-beam CT-guided percutaneous nephrostomies were for pre-lithotripsy access and all 12 were placed in non-dilated collecting systems.
  
  
  RESULTS
  Technical success was 100%. There were no complications.
  
  
  CONCLUSIONS
  Cone-beam CT with 3-D guidance is a technically feasible technique for percutaneous nephrostomy in children and adolescents, specifically for nephrolithotripsy access in non-dilated collecting systems.
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road, Atlanta, GA, 30322, USA. hawkcm@gmail.com.
authors.forename: C Matthew
authors.initials: CM
authors.lastname: Hawkins
authors.affiliation: Department of Radiology, Texas Children's Hospital, Houston, TX, USA.
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Kukreja
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Singewald
authors.affiliation: Department of Urology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Eugene
authors.initials: E
authors.lastname: Minevich
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Neil D
authors.initials: ND
authors.lastname: Johnson
authors.affiliation: Department of Urology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Pramod
authors.initials: P
authors.lastname: Reddy
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Racadio
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D054893:Cone-Beam Computed Tomography / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D008096:Lithotripsy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D009339:Needles; D053040:Nephrolithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation / Q000379:methods*; D011677:Punctures / Q000295:instrumentation / Q000379:methods; D015641:Radiography, Interventional / Q000295:instrumentation / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adolescent; Children; Cone-beam computed tomography; Nephrolithotripsy; Percutaneous nephrostomy