Effects of Allopurinol Dose Escalation on Bone Erosion and Urate Volume in Gout: A Dual‐Energy Computed Tomography Imaging Study Within a Randomized, Controlled Trial

2019 ◽  
Vol 71 (10) ◽  
pp. 1739-1746 ◽  
Author(s):  
Nicola Dalbeth ◽  
Karen Billington ◽  
Anthony Doyle ◽  
Christopher Frampton ◽  
Paul Tan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Randomized Controlled Trial ◽  
Dose Escalation ◽  
Bone Erosion ◽  
Controlled Trial ◽  
Imaging Study ◽  
Dual Energy ◽  
Computed Tomography Imaging ◽  
Tomography Imaging ◽  
Randomized Controlled

scholarly journals Cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy, a randomized controlled trial (CAPTURE) protocol

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
R. A. Kingma ◽  
I. J. de Jong ◽  
M. J. W. Greuter ◽  
S. Roemeling
Keyword(s):  
Computed Tomography ◽  
Randomized Controlled Trial ◽  
Percutaneous Nephrolithotomy ◽  
Cone Beam Computed Tomography ◽  
Controlled Trial ◽  
Cone Beam ◽  
Total Study Population ◽  
Randomized Controlled ◽  
Free Status

Abstract Introduction Percutaneous nephrolithotomy (PCNL) is the standard surgical treatment method for large kidney stones. Its aim is to achieve a stone-free status, since any residual fragments (RFs) after PCNL are likely to cause additional morbidity or stone growth. Enhancing intraoperative detectability of RFs could lead to increased stone-free rates and decreased re-intervention rates. Cone beam computed tomography (CBCT) has recently been introduced in urology as a feasible method for intraoperatively imaging RFs. The aim of this trial is to determine the added value of CBCT in percutaneous nephrolithotomy, by measuring differences in stone-related morbidity for patients with procedures in which a CBCT is used versus patients with procedures without the use of CBCT. Methods The CAPTURE trial is an investigator-initiated single-center, randomized controlled trial (RCT) in adult patients who have an indication for percutaneous nephrolithotomy. A contemporary percutaneous nephrolithotomy is performed. Once the surgeon is convinced of a stone-free status by means of fluoroscopy and nephroscopy, randomization allocates patients to either the study group in whom an intraoperative CBCT scan is performed or to the control group in whom no intraoperative CBCT scan is performed. The main endpoint is the stone-free status as assessed four weeks postoperatively by low-dose non-contrast abdominal CT, as a standard follow-up procedure. Secondary endpoints include the number of PCNL procedures required and the number of stone-related events (SREs) registered. The total study population will consist of 320 patients that undergo PCNL and are eligible for randomization for an intraoperative CBCT scan. Discussion We deem a randomized controlled trial to be the most effective and reliable method to assess the efficacy of CBCT in PCNL. Though some bias may occur due to the impossibility of blinding the urologist at randomization, we estimate that the pragmatic nature of the study, standardized circumstances, and follow-up methods with pre-defined outcome measures will result in a high level of evidence. Trial registration Netherlands Trial Register (NTR) NL8168, ABR NL70728.042.19. Registered on 15 October 2019. Prospectively registered.

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