ABSTRACT
OBJECTIVES: To perform a systematic review on artificial intelligence(AI) performances to detect urinary stones. METHODS: A PROSPERO-registered(CRD473152) systematic search of Scopus, Web of Science, Embase and PubMed databases was performed to identify original research articles pertaining to AI stone detection or measurement, using search terms("automatic" OR "machine learning" OR "convolutional neural network" OR "artificial intelligence" OR "detection" AND "stone volume"). Risk-of-bias(RoB) assessment was performed according to the Cochrane RoB tool, the Joanna Briggs Institute Checklist for nonrandomized studies and the Checklist for Artificial Intelligence in Medical Imaging(CLAIM). RESULTS: Twelve studies were selected for final review, including 3 multicenter and 9 single-center retrospective studies. 11 studies completed at least 50% of the CLAIM checkpoints and only one presented a high ROB. All included studies aimed to detect on kidney(5/12, 42%), ureter(2/12, 16%) or urinary(5/12, 42%) stones on Non-Contrast Computed Tomography(NCCT), but 42% intended to automate measurement. Stone distinction from vascular calcification interested 2 studies. All studies used AI machine learning network training and internal validation, but a single one provided an external validation. Trained networks achieved stone detection with sensitivity, specificity and accuracy rates ranging from 58,.7 to 100%, 68,.5 to 100% and 63 to 99,.95%, respectively. Detection Dice score ranged from 83% to 97%. A high correlation between manual and automated Stone Volume(r=0,.95) was noted. Differentiate distal ureteral stones and phleboliths seemed feasible. CONCLUSIONS: Artificial Intelligence processes can achieve automated urinary stone detection from NCCT. Further studies should provide urinary stones detection coupled with phlebolith distinction and an external validation, and include anatomical abnormalities and urological foreign bodies (ureteral stent and nephrostomy tubes) cases.
ABSTRACT
Juvenile gangrenous vasculitis of the scrotum is a rare entity, of which to our knowledge we describe the first documented case in the UK. It follows a typical disease course, demonstrated by an 18-year-old male who presented with three necrotic scrotal lesions; proceeded by 3 days of fever, pharyngitis and lethargy. Previous cases have been managed successfully with systemic steroids. On this occasion, surgical debridement was made of the necrotic areas under antibiotic cover and complete resolution was achieved with excellent wound healing and no evidence of recurrence. This case report discusses the importance of disease recognition and the merits of surgical management. We also add to the debate as to whether this disease is a variation of pyoderma gangrenosum or a distinct entity itself within the pantheon of scrotal gangrene.
