{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T08:30:13Z","timestamp":1786437013423,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003819","name":"Natural Science Foundation of Hubei Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003819","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess whether computed tomography\u2013ultrasonography (CT\u2013US) fusion navigation, compared with conventional US guidance, improves first\u2010pass success and related access outcomes in a multicentre randomised trial, as accurate renal access is critical in percutaneous nephrolithotomy (PCNL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>Between March and December 2024, 180 adults with renal stones &gt;2\u2009cm scheduled for PCNL at five centres in China were randomised (1:1, stratified by centre) to CT\u2013US fusion or conventional US guidance. The primary outcome was first\u2010pass success (guidewire in pre\u2010specified target calyx with single capsular traversal). Secondary outcomes included puncture attempts, 24\u2010h haemoglobin drop, major bleeding complications (per\u2010patient composite of transfusion or angiographic embolisation), 30\u2010day stone\u2010free rate (no fragments \u22654\u2009mm on non\u2010contrast CT), overall complications, hospital stay, and surgeon procedural comfort. Analyses were intention\u2010to\u2010treat.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      First\u2010pass success was higher with CT\u2013US fusion (93.3% vs 78.9%; risk ratio 1.18, 95% confidence interval [CI] 1.05\u20131.33; risk difference [RD] 14.4%, 95% CI 4.3\u201324.6%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.009). Haemoglobin drop was smaller (mean difference \u22123.45\u2009g\/L, 95% CI \u22126.53 to \u22120.37\u2009g\/L;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.028). Major bleeding complications occurred only in the conventional US group (0% vs 6.7%; RD \u22126.7%, 95% CI \u221213.8% to \u22121.2%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.029; exploratory). Stone\u2010free rates, overall complications, and hospital stay were similar. Procedural comfort was rated higher with CT\u2013US fusion on the 5\u2010point Likert scale (median score 5 vs 3;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with conventional US guidance, CT\u2013US fusion improved first\u2010pass success during PCNL and was associated with a smaller 24\u2010h haemoglobin drop without compromising efficacy. Further studies are needed to evaluate rare major bleeding events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70325","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T04:40:32Z","timestamp":1779511232000},"page":"409-416","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>Computed tomography<\/scp>\n                    \u2013ultrasonography (US) fusion for percutaneous nephrolithotomy access versus conventional US: A multicentre randomised trial"],"prefix":"10.1111","volume":"138","author":[{"given":"Bojun","family":"Li","sequence":"first","affiliation":[{"name":"Department of Urology Renmin Hospital of Wuhan University  Wuhan China"},{"name":"Hubei Provincial Key Laboratory for Precision Diagnosis and Treatment of Urogenital Diseases and Medical\u2010Engineering Integration  Wuhan Hubei China"},{"name":"Engineering Research Center for Intelligent 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