AUTHOR=Huang Haiwen , Song Haifeng , Ding Tianfu , Xu YangYang , Fan Yunfei , Su Boxing , Liu Yubao , Hu Weiguo , Xiao Bo , Li Jianxing 

TITLE=B.T.C.H. nephrolithometry score: a novel scoring system to predict stone-free rate and complexity for ultrasound-guided percutaneous nephrolithotomy

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1557702

DOI=10.3389/fmed.2025.1557702

ISSN=2296-858X

ABSTRACT=BackgroundThe existing scoring systems for percutaneous nephrolithotomy fail to adequately consider the influence of renal anatomy, leading to limited predictive accuracy. This study introduces and validates a novel B.T.C.H. nephrolithometry score, designed to better predict stone-free rates and complexity for ultrasound-guided percutaneous nephrolithotomy.MethodsB.T.C.H. nephrolithometry score evaluates four variables including stone burden, type of renal pelvis, calyces involved, and hydronephrosis. 134 patients who underwent ultrasound-guided percutaneous nephrolithotomy at Beijing Tsinghua Changgung Hospital were retrospectively analyzed. The inter-observer agreement was assessed using the linearly weighted kappa coefficient. The accuracy in predicting the stone-free rate was evaluated using receiver operating characteristic curve analysis. Spearman’s correlation analysis and Kendall’s W test were employed to examine the correlation between the scores of each scoring system and operative time, the number of tracts and CDC scores.ResultsThe overall stone-free rate was 52.99%. The stone-free rates in low (4–8 points), medium (9–12 points), and high (13–15 points) B.T.C.H. scores were 91.9, 24.6, and 0%, respectively. The B.T.C.H. nephrolithometry score had an AUC of 0.909 for predicting stone-free rate, outperforming both the GSS (AUC = 0.761) and the S.T.O.N.E. nephrolithometry score (AUC = 0.763). The B.T.C.H. nephrolithometry score were positively correlated with operative time, the number of tracts and CDC scores.ConclusionB.T.C.H. nephrolithometry score is a suggested novel scoring system for ultrasound-guided percutaneous nephrolithotomy, which had superior prediction of stone-free rate and positive correlation with operative time, the number of tracts, and postoperative CDC scores.