Application of 3DSlicer Technology in Percutaneous Nephrolithotomy Surgery.

The Application of 3DSlicer Technology in Percutaneous Nephrolithotomy Surgery.

Objectives: Percutaneous nephrolithotomy (PCNL) has become a widely used technique for managing renal calculi. However, the rate of residual stones remains high. Accurate preoperative assessment of the individual's renal collecting system anatomy and strategic planning of access pathways are essential for improving stone-free outcomes. This study investigated whether characteristics of the target calyx can predict stone clearance through a distinct puncture calyx and developed a model to estimate the risk of residual stones in the target calyx.

Methods: We performed a retrospective analysis of patients who underwent PCNL in the urology department of our center between January 2023 and June 2025, in whom the puncture calyx differed from the target calyx (67 cases with complete stone clearance and 38 cases with residual stones). Three-dimensional reconstructions of the renal collecting system and calculi were generated from preoperative urinary tract CT scans, and spatial parameters were obtained from these models. Patient and stone characteristics were combined with 3D-derived variables for binary logistic regression to identify predictive factors and construct nomograms. Model performance was assessed using receiver operating characteristic (ROC) and calibration curves, while clinical utility was evaluated through decision curve analysis (DCA). The Youden index was applied to determine the optimal cutoff value.

Study Overview

• Status: Completed
• Conditions: Percutaneous Nephrolithotomy

• Study Type: Observational
• Enrollment (Actual): 105

Contacts and Locations

Study Locations

• China
  • Zhejiang
    • Jinhua, Zhejiang, China, 321000
      • Department of Urology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine,

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

After applying these criteria, a total of 105 renal calyces were included for analysis

Description

Inclusion Criteria:

① preoperative diagnosis of renal calculi confirmed by computed tomography urography (CTU); ② completion of standard-channel (F24) PCNL with the puncture and target calyces situated in different renal calyces; and ③ postoperative CT imaging performed within one week after surgery.

Exclusion Criteria:

① anatomical abnormalities of the affected kidney, such as severe renal rotation or horseshoe kidney; and ② history of secondary procedures, including repeat PCNL or renal puncture with fistula formation.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Stone Free Group
Stone Residue Group

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
predict the stone free possibility of kidey stone	AUC curve	2023-2025
predict the stone free possibility of kidey stone	DCA curve	2023-2025

Collaborators and Investigators

• Sponsor: Ting Huang

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2023
• Primary Completion (Actual): June 30, 2025
• Study Completion (Actual): June 30, 2025

Study Registration Dates

• First Submitted: December 10, 2025
• First Submitted That Met QC Criteria: December 10, 2025
• First Posted (Actual): December 23, 2025

Study Record Updates

• Last Update Posted (Actual): December 23, 2025
• Last Update Submitted That Met QC Criteria: December 10, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: 2022282

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No