Estimation of urinary stone composition by automated processing of CT images

Chevreau, Grégoire; Troccaz, Jocelyne; Conort, Pierre; Renard-Penna, R.; Mallet, Alain; Daudon, Michel; Mozer, Pierre

doi:10.1007/s00240-009-0195-3

Cited by 22 publications

(7 citation statements)

References 13 publications

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“…NCCT has become the preferred imaging modality for the diagnosis and management of urolithiasis [15,16]. In addition, the attenuation value of the calculi measured as HUs obtained by NCCT may be used to predict their mineral composition [4,11,[13][14][15][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Predicting the mineral composition of ureteral stone using non-contrast computed tomography

et al. 2015

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We investigated the correlation between computed tomography (CT) density of ureteral stones and their mineral composition. A total of 346 patients who underwent ureteroscopic lithotripsy for calculi all fragments of which were acquired at a single institution from 2009 to 2011 were analyzed. The maximum and mean CT densities were measured preoperatively. A mineral analysis revealed calcium oxalate in 203 (58.7 %), mixed calcium oxalate and calcium phosphate in 78 (23.0 %), calcium phosphate in 18 (5.2 %), uric acid in 8 (2.3 %), struvite in 3 (0.9 %), and cysteine in 5 (1.4 %). The mean Hounsfield units (HUs) of the CT density were 1046 HUs in calcium oxalate, 1101 HUs in mixed calcium oxalate and calcium phosphate, 835 HUs in calcium phosphate, 549 HUs in uric acid, 729 HUs in struvite, and 698 HUs in cystine. The HUs in calcium oxalate were significantly higher than those in uric acid (p < 0.01) and struvite (p < 0.01). Those in monohydrate stones were significantly higher, compared with dehydrate stones (p < 0.05). We analyzed the largest number of stones than each published study to correlate their mineral composition and CT density. Calcium component stones showed significantly higher CT densities than other types.

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Section: Discussionmentioning

confidence: 99%

Predicting the mineral composition of ureteral stone using non-contrast computed tomography

et al. 2015

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“…In reports, uric acid stones have values of 200-400 HU at 120 kV in vivo and calcium oxalate stones have higher values [11]. To obtain accurate data on urinary stone's CT-attenuation value, many different measurement methods have been recorded in image analysis, such as calculating the mean of ROIs (randomly or in three vertical pixels) or developing automated image processing software [12,13]. Brian et al [13] performed a test to compare urinary stone's CT-attenuation value in three different measurement methods and obtained similar results with significant difference.…”

Section: Discussionmentioning

confidence: 99%

Prediction of calcium level in melamine-related urinary calculi with helical CT: diagnostic performance evaluation and clinical significance

Li¹,

XiaoRui²,

Huang³

et al. 2011

Urol Res

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The aim of the study was to investigate the relationship between CT-attenuation and stone calcium level in melamine-related urinary calculi (MRUC). A total of 25 MRUC with known composition and calcium level were included (11 uric acid stones, 2 calcium oxalate stones and 12 mixture stones of uric acid and calcium oxalate). Of all, 18 renal stones accepted alkalization therapy except for 5 lower urinary tract stones and 2 stones of unknown position. With well-matched composition, 61 adult urinary stones were included as controls. Every stone was scanned by helical CT (80 kV/120 kV, 300 mA, pitch 0.625 mm) and the highest CT-attenuation value measured. CT-attenuation values of MRUC increased gradually from uric acid stones, mixture stones to calcium oxalate stones, but were always lower than the values of controls. Furthermore, a strong positive correlation was found between stone CT-attenuation value and stone calcium level (n = 25, r 80kV = 0.883, p = 0.000; r 120kV = 0.855, p = 0.000). Compared with alkalization-therapy-alone group, stone CTattenuation values and stone calcium level in the comprehensive-therapy group were significantly greater (CT 80kV 1,057 ± 639 vs. 172 ± 61 HU, p = 0.001; CT 120kV 783 ± 476 vs. 162 ± 60 HU, p = 0.001; Ca 19.83 ± 7.48% vs. 1.30 ± 1.51%, p = 0.000). Fisher's exact test suggested that the stones with higher CT-attenuation values tended to resist alkalization when 400 HU served as the cutoff value (P 80kV = 0.002, P 120kV = 0.000). In conclusion, the study was the first to illustrate that the CT-attenuation value could reflect calcium level in MRUC and found that stones with higher CT-attenuation value were not amenable to alkalization because they probably contained greater calcium. For those patients, we believe that comprehensive therapy will be the best choice.

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“…CT without contrast has become mode of choice in the diagnosis of acute flank pain [13][14][15] . Main benefits of non-contrast CT scan are high sensitivity and specificity in the diagnosis of renal tract calculi, high speed, diagnosis of other pathologies and cost.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Shockwave Lithotripsy

Akbar¹,

Mahmood²,

Majid³

2015

TPMJ

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Objective: To evaluate the effect of urinary calculi attenuation values fromnon enhanced computed tomography (stone radiodensity) and stone size in determiningthe outcome of treatment by ESWL. Study design: Descriptive case series study. Setting:Department of Diagnostic Radiology, Lahore General Hospital Lahore, in collaboration with theDepartment of Urology, Lahore General Hospital Lahore. Duration of study with dates: Studywas carried out over a period of six months from January 2012 to July 2012. Subjects andMethods: Seventy patients with solitary renal calculus of 05 mm – 20 mm size were evaluatedfor calculus attenuation values in Hounsfield Units on non enhanced computed tomography.Patients were being grouped according to calculus attenuation values as: 1) less than 500 HU(soft) 2) 500-1000 HU (medium) 3) more than 1000 HU (Hard). Patients were also distributed inthree groups according to stone size as: 1) 5-10 mm 2) 11-15 mm 3) 16-20 mm. Patients werebeing subsequently treated with ESWL. During each ESWL session 3000 shockwaves weregiven. Stone clearance was documented by USG within three month after start of treatment.Results: Out of 70 patients stones were cleared in 84.3% (n=59) patients. According to thestone density, the rate of stone clearance was 100% (n=19) in group 1, 88.9% (n=27) in group2 and 66.7% (n=24) in group 3. Regarding the stone size, stones were cleared in 88.9% (n=9)in group 1, 77.4% (n=31) and 90% (n=30) in group 3. The best outcome was in patients withstone diameter of 16-20 mm and a density of < 500 HU. The worst outcome was in patients withstone diameter of 11-15 mm and a density of >1000 HU. Conclusions: The attenuation valueof stone has a greater impact on ESWL outcome than the stone size. Further these attenuationvalues of urinary tract stones before ESWL helps in determining the treatment outcome and inplanning alternative treatment in patients with likelihood of poor outcome from ESWL.

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Estimation of urinary stone composition by automated processing of CT images

Cited by 22 publications

References 13 publications

Predicting the mineral composition of ureteral stone using non-contrast computed tomography

Predicting the mineral composition of ureteral stone using non-contrast computed tomography

Prediction of calcium level in melamine-related urinary calculi with helical CT: diagnostic performance evaluation and clinical significance

Extracorporeal Shockwave Lithotripsy

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