Piyawannarat S.Sirisopana K.Phengsalae Y.Sangkum P.Kongchareonsombat W.Ketsuwan C.Mahidol University2026-02-152026-02-152026-03-01Urology Case Reports Vol.65 (2026)22144420https://repository.li.mahidol.ac.th/handle/123456789/115058Pediatric patients are particularly susceptible to ionizing radiation risks. A fluoroscopy-free mini-percutaneous nephrolithotomy (mini-PCNL) was performed using computed tomography (CT)–ultrasound fusion guidance for recurrent cystine nephrolithiasis in a 12-year-old boy. Renal access and complete stone clearance were achieved. Integrating preoperative CT with real-time ultrasonography enabled precise targeting, overcoming limitations of ultrasound-only guidance. The procedure was completed safely, with minimal blood loss and 90-min operative time. CT–ultrasound fusion-guided mini-PCNL is a feasible radiation-sparing approach for pediatric patients with complex renal stones.MedicineArticleSCOPUS10.1016/j.eucr.2026.1033672-s2.0-105029594452