, Volume 47, Issue 6, pp 557–565 | Cite as

Do 3D-calculated volume distribution of a stone in pelvicalyceal system affect complications of percutaneous nephrolithotomy?

  • Sait ÖzbirEmail author
  • Hasan Anıl Atalay
  • Halil Lütfi Canat
  • Mehmet Gökhan Çulha
Original Paper


In our study, we examined the effect of the three-dimensional (3D) stone segmentation volume and its ratio to the renal collecting system on complication rates. Data from141 patients who underwent PCNL surgery were analyzed retrospectively. Volume segmentation of both the renal collecting system and stones was obtained from 3D segmentation software with the images on CT data. After creation of a 3D surface volume rendering of renal stones and the collecting system, segmentation of the renal collecting system volume (RCSV) and analyzed stone volume (ASV) was analyzed and the ASV-to-RCSV ratio was calculated. Univariate analysis and multivariate logistic regression model were used to determine factors that affected complication status. Diagnostic value for the prediction of complication rates was analyzed using receiver operating characteristic (ROC) incline. Overall, there were 141 (92 male and 49 female) eligible patients included in the current study. The overall complication rate for PCNL monotherapy was 31.9%. Multivariate regression analysis (forward stepwise) revealed that the ASV-to-RCSV ratio and number of tracts were independent risk factors for developing complications (OR 1.17, p < 0.001; OR 7.87, p = 0.002; respectively). The ROC analysis revealed a cut-off value of 16.23% (AUC 0.869, p < 0.001, sensitivity 93.3%, specificity 78.1%) for the ASV-to-RCSV ratio. The distribution of stone burden volume in the pelvicalyceal system, which is calculated as a numerical value using the 3D volume segmentation method, is an important predictor of the complication rate before PCNL. The ASV-to-RCSV ratio as a quantitative value may be an instrument for urologists before surgery to help preoperative planning.


Percutaneous nephrolithotomy 3D volume segmentation Complication Three dimensions 



Area under curve


Analyzed stone burden volume


Body mass index


Computed tomography


Digital imaging and communications in medicine


Odds ratio


Percutaneous nephrolithotomy


Renal collecting system volume


Receiver operating characteristic


Three dimensional


Compliance with ethical standards

Conflict of interest

Sait Özbir, Hasan Anıl Atalay, Halil Lütfi Canat and Mehmet Gökhan Çulha each declare no potential conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UrologyOkmeydanı Training and Research HospitalIstanbulTurkey

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