{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T05:42:53Z","timestamp":1792734173693,"version":"4.5.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>B.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\u2019s correlation analysis and Kendall\u2019s 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall stone-free rate was 52.99%. The stone-free rates in low (4\u20138 points), medium (9\u201312 points), and high (13\u201315 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\u202f=\u202f0.761) and the S.T.O.N.E. nephrolithometry score (AUC\u202f=\u202f0.763). The B.T.C.H. nephrolithometry score were positively correlated with operative time, the number of tracts and CDC scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>B.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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1557702","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T05:26:16Z","timestamp":1746681976000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["B.T.C.H. nephrolithometry score: a novel scoring system to predict stone-free rate and complexity for ultrasound-guided percutaneous nephrolithotomy"],"prefix":"10.3389","volume":"12","author":[{"given":"Haiwen","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haifeng","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianfu","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YangYang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfei","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boxing","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yubao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiguo","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1016\/j.ijsu.2016.11.028","article-title":"Percutaneous nephrolithotomy (PCNL) a critical review","volume":"36","author":"Ganpule","year":"2016","journal-title":"Int J Surg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/j.urology.2010.12.026","article-title":"The Guy's stone score--grading the complexity of percutaneous nephrolithotomy procedures","volume":"78","author":"Thomas","year":"2011","journal-title":"Urology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.1016\/j.urology.2012.10.083","article-title":"S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi","volume":"81","author":"Okhunov","year":"2013","journal-title":"Urology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.juro.2013.01.047","article-title":"A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy","volume":"190","author":"Smith","year":"2013","journal-title":"J Urol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e65888","DOI":"10.1371\/journal.pone.0065888","article-title":"Seoul National University renal stone complexity score for predicting stone-free rate after percutaneous nephrolithotomy","volume":"8","author":"Jeong","year":"2013","journal-title":"PLoS One"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1038\/nrurol.2017.71","article-title":"Current clinical scoring systems of percutaneous nephrolithotomy outcomes","volume":"14","author":"Wu","year":"2017","journal-title":"Nat Rev Urol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1089\/end.2018.0218","article-title":"Proposal for a simple anatomical classification of the pelvicaliceal system for endoscopic surgery","volume":"32","author":"Takazawa","year":"2018","journal-title":"J Endourol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1097\/SLA.0b013e3181b13ca2","article-title":"The Clavien-Dindo classification of surgical complications: five-year experience","volume":"250","author":"Clavien","year":"2009","journal-title":"Ann Surg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"4184","DOI":"10.3760\/cma.j.issn.0366-6999.20141447","article-title":"Complication and safety of ultrasound guided percutaneous nephrolithotomy in 8,025 cases in China","volume":"127","author":"Li","year":"2014","journal-title":"Chin Med J"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1007\/s00345-018-2458-5","article-title":"Long-term outcomes of ultrasound-guided percutaneous nephrolithotomy in patients with solitary kidneys: a single-center experience","volume":"37","author":"Su","year":"2019","journal-title":"World J Urol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/s12894-019-0488-y","article-title":"Evaluation of three stone-scoring systems for predicting SFR and complications after percutaneous nephrolithotomy: a systematic review and meta-analysis","volume":"19","author":"Jiang","year":"2019","journal-title":"BMC Urol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1016\/j.jpurol.2024.07.030","article-title":"Validation of stone-kidney size score to predict outcome and complications of pediatric percutaneous nephrolithotomy","volume":"20","author":"Aslan","year":"2024","journal-title":"J Pediatr Urol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.1089\/end.2021.0124","article-title":"Atlas of scoring systems, grading tools, and nomograms in endourology: a comprehensive overview from the TOWER endourological society research group","volume":"35","author":"Jones","year":"2021","journal-title":"J Endourol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1590\/s1677-5538.ibju.2024.9901","article-title":"Kidney collecting system anatomy applied to endourology - a narrative review","volume":"50","author":"Morais","year":"2024","journal-title":"Int Braz J"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2944","DOI":"10.21037\/tau-21-309","article-title":"Modified Takazawa anatomical classification of renal pelvicalyceal system based on three-dimensional virtual reconstruction models","volume":"10","author":"Zhu","year":"2021","journal-title":"Trans Androl Urol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/j.ajur.2018.12.006","article-title":"Revisiting the morphology of pelvicalyceal system in human cadaveric kidneys with a systematic review of literature","volume":"6","author":"Gandhi","year":"2019","journal-title":"Asian J Urol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1356","DOI":"10.1186\/s40064-016-3017-4","article-title":"Complex multiple renal calculi: stone distribution, pelvicalyceal anatomy and site of puncture as predictors of PCNL outcome","volume":"5","author":"Verma","year":"2016","journal-title":"Springerplus"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1007\/s00240-017-0995-9","article-title":"Evaluation of stone volume distribution in renal collecting system as a predictor of stone-free rate after percutaneous nephrolithotomy: a retrospective single-center study","volume":"46","author":"Atalay","year":"2018","journal-title":"Urolithiasis"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.urology.2016.09.031","article-title":"X-ray-free ultrasound-guided percutaneous nephrolithotomy: how to select the right patient?","volume":"100","author":"Usawachintachit","year":"2017","journal-title":"Urology"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"8","DOI":"10.22037\/uj.v0i0.4826","article-title":"Is absence of hydronephrosis a risk factor for bleeding in conventional percutaneous nephrolithotomy","volume":"17","author":"Kim","year":"2020","journal-title":"Urol J"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1557702\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T05:26:17Z","timestamp":1746681977000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1557702\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,8]]},"references-count":20,"alternative-id":["10.3389\/fmed.2025.1557702"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1557702","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,8]]},"article-number":"1557702"}}