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3. Comparative effectiveness of paediatric kidney stone surgery (the PKIDS trial): study protocol for a patient-centred pragmatic clinical trial

Author

Ellison, Jonathan S, Lorenzo, Matthew, Beck, Hunter, Beck, Ruth, Chu, David I, Forrest, Christopher, Huang, Jing, Kratchman, Amy, Kurth, Anna, Kurth, Laura, Kurtz, Michael, Lendvay, Thomas, Sturm, Renae, Tasian, Gregory, Srinivasan, Arun K, Denburg, Michelle, Back, Susan J, Ching, Christina B, DeFoor, William Robert, Bani-Hani, Ahmad H, Ellsworth, Pamela I, Stec, Andrew A, Fernández, Nicolás, Rove, Kyle, Nelson, Caleb P, Coplen, Douglas E, Bayne, Christopher E, Dangle, Pankaj P, Krill, Aaron, Baker, Linda A, Janzen, Nicolette K, Taylor, Abby S, Cerwinka, Wolfgang H, Nelson, Eric D, Ziemba, Justin B, Casale, Pasquale, Misseri, Rosalia, Kraft, Kate H, Meenakshi-Sundaram, Bhalaajee, Lorenzo, Armando, and Fermin, Antoine Selman

Subjects
Health Services and Systems, Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Clinical Trials and Supportive Activities, Health Services, Kidney Disease, Clinical Research, Comparative Effectiveness Research, Patient Safety, Urologic Diseases, 6.4 Surgery, Evaluation of treatments and therapeutic interventions, Good Health and Well Being, Adolescent, Adult, Child, Humans, Kidney Calculi, Lithotripsy, Pragmatic Clinical Trials as Topic, Prospective Studies, Treatment Outcome, Ureteroscopy, Young Adult, Pediatric KIDney Stone Care Improvement Network, Clinical trials, Protocols & guidelines, UROLOGY, Public Health and Health Services, Other Medical and Health Sciences, Biomedical and clinical sciences, Health sciences, Psychology
Abstract

IntroductionThe strength of the evidence base for the comparative effectiveness of three common surgical modalities for paediatric nephrolithiasis (ureteroscopy, shockwave lithotripsy and percutaneous nephrolithotomy) and its relevance to patients and caregivers are insufficient. We describe the methods and rationale for the Pediatric KIDney Stone (PKIDS) Care Improvement Network Trial with the aim to compare effectiveness of surgical modalities in paediatric nephrolithiasis based on stone clearance and lived patient experiences. This protocol serves as a patient-centred alternative to randomised controlled trials for interventions where clinical equipoise is lacking.Methods and analysisThe PKIDS is a collaborative learning organisation composed of 26 hospitals that is conducting a prospective pragmatic clinical trial comparing the effectiveness of ureteroscopy, shockwave lithotripsy and percutaneous nephrolithotomy for youth aged 8-21 years with kidney and/or ureteral stones. Embedded within clinical care, the PKIDS trial will collect granular patient-level, surgeon-level and institution-level data, with a goal enrolment of 1290 participants over a 21-month period. The primary study outcome is stone clearance, defined as absence of a residual calculus of >4 mm on postoperative ultrasound. Secondary outcomes include patient-reported physical, emotional and social health outcomes (primarily using the Patient-Reported Outcome Measurement Information System), analgesic use and healthcare resource use. Timing and content of secondary outcomes assessments were set based on feedback from patient partners. Heterogeneity of treatment effect for stone clearance and patient-reported outcomes by participant and stone characteristics will be assessed.Ethics and disseminationThis study is approved by the central institutional review board with reliance across participating sites. Participating stakeholders will review results and contribute to development dissemination at regional, national and international meetings.Trial registration numberNCT04285658; Pre-results.

Published
2022

12. Female Genital Tract

Author

Gould, Sharon W., Calle Toro, Juan S., Back, Susan J., Podberesky, Daniel J., Epelman, Monica, Lee, Edward Y., editor, Liszewski, Mark C., editor, Gee, Michael S., editor, Daltro, Pedro, editor, and Restrepo, Ricardo, editor

Published
2020
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18. Contrast-enhanced voiding urosonography part 2: urethral imaging

Author

Barnewolt, Carol E., Acharya, Patricia T., Aguirre Pascual, Elisa, Back, Susan J., Beltrán Salazar, Vivian P., Chan, Pui Kwan Joyce, Chow, Jeanne S., Coca Robinot, David, Darge, Kassa, Duran, Carmina, Ključevšek, Damjana, Kwon, Jeannie K., Ntoulia, Aikaterini, Papadopoulou, Frederica, Woźniak, Magdalena M., and Piskunowicz, Maciej

Published
2021
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25. Utility of contrast-enhanced ultrasound for solid mass surveillance and characterization in children with tuberous sclerosis complex: an initial experience

Author

Chan, Joyce PK, Back, Susan J, Vatsky, Seth, Calle-Toro, Juan S, Khrichenko, Dimitry, Sridharan, Anush, and Poznick, Laura

Subjects
Children -- Diseases, Kidney cancer -- Diagnosis -- Risk factors, Diagnosis, Ultrasonic -- Methods -- Usage, Tuberous sclerosis -- Complications and side effects, Health
Abstract

Background Patients with tuberous sclerosis complex (TSC) can develop solid kidney masses from childhood. Imaging surveillance is done to detect renal cell carcinoma (RCC) and angiomyolipomas (AML), including AMLs at risk for hemorrhage. Intravenous contrast-enhanced ultrasound (CEUS) may be useful for screening as ultrasound is well tolerated by children and ultrasound contrast agents (UCA) are not nephrotoxic. Methods Retrospective review of kidney CEUS exams of pediatric TSC patients. Qualitative CEUS analysis by consensus of 3 radiologists assessed rate, intensity, and pattern of lesion enhancement. Quantitative CEUS analysis was performed using Vuebox®. Where available, abdominal MRI was analyzed qualitatively for the same features and quantitatively by in-house-developed software. Time-intensity curves were generated from both CEUS and MRI where possible. Appearance of lesions were compared between CEUS and MRI and histology where available. Results Nine masses in 5 patients included one histologically proven RCC and 8 AMLs diagnosed by imaging. Quantitative CEUS of RCC showed malignant features including increased peak enhancement 162%, rapid wash-in rate 162%, and elevated washout rate 156% compared to normal kidney tissue; versus AML which was 68%, 105%, and 125%, respectively. All masses were hypoenhancing on MRI compared to normal kidney tissue; MR dynamic contrast study offered no distinction between RCC and AML. The only MRI feature differentiating RCC from AML was absence of fat. Conclusion Temporal resolution afforded by CEUS was useful to distinguish malignant from benign kidney masses. CEUS may prove useful for screening, characterizing, and follow-up of kidney lesions in pediatric TSC patients., Author(s): Joyce PK Chan [sup.1] , Susan J Back [sup.1] , Seth Vatsky [sup.1] , Juan S Calle-Toro [sup.1] , Dimitry Khrichenko [sup.1] , Anush Sridharan [sup.1] , Laura Poznick [...]

Published
2021
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32. Recommendations for Preclinical Renal MRI: A Comprehensive Open-Access Protocol Collection to Improve Training, Reproducibility, and Comparability of Studies

Author

Pohlmann, Andreas, primary, Back, Susan J., additional, Fekete, Andrea, additional, Friedli, Iris, additional, Hectors, Stefanie, additional, Jerome, Neil Peter, additional, Ku, Min-Chi, additional, Longo, Dario Livio, additional, Meier, Martin, additional, Millward, Jason M., additional, Periquito, João S., additional, Seeliger, Erdmann, additional, Serai, Suraj D., additional, Waiczies, Sonia, additional, Sourbron, Steven, additional, Laustsen, Christoffer, additional, and Niendorf, Thoralf, additional

Published
2021
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33. Insights into Kidney Dysplasia in Duplex Kidneys: From Radiologic Diagnosis to Histopathologic Understanding.

Author

Świętoń, Dominik, Buczkowski, Kamil, Czarniak, Piotr, Gołębiewski, Andrzej, Grzywińska, Małgorzata, Kujawa, Mariusz J., Back, Susan J., Piskunowicz, Maciej, and Iżycka-Świeszewska, Ewa

Subjects
KIDNEYS, DYSPLASIA, URINARY organs, MAGNETIC resonance imaging, DIAGNOSIS, KIDNEY transplantation, ACOUSTIC radiation force impulse imaging, VESICO-ureteral reflux
Abstract

Duplex kidney is a urinary tract anomaly commonly associated with a wide range of primary and secondary parenchymal structural abnormalities. We present a unique comparison of US and MRI findings with histopathology following partial resection of duplex kidneys due to nephropathy. We examined a group of 21 children with duplex kidneys who were qualified for heminephrectomy (24 kidney units (KU)). All patients underwent US and MRI prior to the surgery. The imaging results were compared with histopathologic findings. In 21/24 KU, dysplastic changes were found on histopathology, including all with obstructive nephropathy and 7/10 specimens with refluxing uropathy. The loss of corticomedullary differentiation on US and increased signal on T2-weighted images (T2WI) on MRI were the imaging findings that best correlated with fibrosis. In children with megaureter, there were no statistical differences in histopathological findings between primary megaureter, megaureter with ureterocele, and megaureter with ectopia (p > 0.05). The extent of dysplasia of the affected pole correlated negatively with residual function in MRI. Kidney dysplasia and inflammation in the kidney with obstructive nephropathy are the most important histopathologic findings of this study. US is a valuable screening tool, and MRI enables morphologic and functional assessments of the nephropathy in duplex kidneys. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Safety of Ultrasound Contrast Agents in Pediatric Patients With Sickle Cell Disease and Trait.

Author

Ntoulia, Aikaterini, Darge, Kassa, Thompson, Alexis A., and Back, Susan J.

Subjects
SICKLE cell trait, ULTRASOUND contrast media, SICKLE cell anemia, CONTRAST-enhanced ultrasound, CHILD patients, FIDDLER crabs
Abstract

Ultrasound contrast agent (UCA) use is increasing. Recent isolated reports observed a rise in pain‐related adverse events with the intravenous administration of the UCA Definity in adults with sickle cell disease. To date, no studies have investigated the incidence of similar adverse events with UCA Lumason or Optison. We describe our experience regarding the safety of Lumason and Optison in children with sickle cell disease and trait who underwent contrast‐enhanced ultrasound exams in our department with intravenous, intravesical, and other intracavitary routes. No pain‐related or other adverse events were observed in this pediatric population with any route of UCA administration. [ABSTRACT FROM AUTHOR]

Published
2024
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