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BioMed Research International
Volume 2017 (2017), Article ID 7802672, 7 pages
Research Article

Ultrasonography Is Not Inferior to Fluoroscopy to Guide Extracorporeal Shock Waves during Treatment of Renal and Upper Ureteric Calculi: A Randomized Prospective Study

1Department of Urology, AZ Sint-Lucas, Ghent, Belgium
2Department of Radiology, AZ Sint-Jan, Bruges, Belgium
3Department of Urology, University Hospitals, Ghent, Belgium

Correspondence should be addressed to Jeroen Van Besien

Received 26 January 2017; Accepted 29 March 2017; Published 15 May 2017

Academic Editor: Adair Santos

Copyright © 2017 Jeroen Van Besien et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To investigate whether the visualization modality (ultrasound or fluoroscopy) used during shockwave lithotripsy (SWL) affects the clinical outcome in those instances where both imaging modalities are optional. Methods. Between November 2014 and July 2016, 114 patients with radiopaque upper urinary tract calculi were randomly assigned to an ultrasound- or fluoroscopy-guided SWL group in a prospective, open-label, single-center study. A standardized SWL protocol was used. The stone-free rate and the positive outcome rate (stone-free or asymptomatic residual fragments ≤ 4 mm) were compared. Results. The stone-free rate was 52% in the ultrasound-guided group compared to 42% in the fluoroscopy-guided group ( = 0.06) and the positive outcome rate was 79% in the ultrasound-guided group compared to 70% in the fluoroscopy-guided group ( = 0.28). These results were not significantly different but proved to be noninferior based on a Wilson confidence interval of independent proportions (noninferiority limit 10%). The mean number of SWL sessions was not significantly different ( = 0.4). Conclusion. Our study demonstrated that the clinical results of ultrasound-guided SWL were not inferior to the results of fluoroscopy-guided SWL, while no ionizing radiation is needed.