Imaging Advances in Urolithiasis

Abstract

The prevalence of urinary stones in the United States has been described as 1 in 11 persons reporting a history of stones. Imaging plays a crucial role in diagnosis, management, and follow-up for these patients and imaging technology over the last 100 years has advanced as the disease prevalence has increased. CT remains the gold standard for imaging urolithiasis and changes in this technology, with the addition of multidetector CT and dual-energy CT, as well as the changes in utilization of CT, have decreased the radiation dose encountered by patients and allowed for improved stone detection. The use of digital tomography has been introduced for follow-up of recurrent stone formers offering the potential to lower radiation exposure over the course of a patient's lifelong treatment. However, there is still a demand for improved imaging techniques to detect smaller stones and stones in larger patients at lower radiation doses as well as the continued need for the judicious use of all imaging modalities for healthcare cost containment and patient safety.

In vitro analysis of urinary stone composition in dual-energy computed tomography

“…DECT allows deposits containing uric acid to be distinguished from deposits which do not contain uric acid, in tests performed both in vivo and in vitro [6]. Due to the different chemical structure, uric acid deposits show higher radiodensity Hounsfield unit values using high-energy radiation (at higher kilovoltage), while other types of deposits (including calcium deposits) show higher radiodensity Hounsfield unit values using low-energy radiation (low kilovoltage) [7].…”

A User-Friendly Application to Automate CT Renal Stone Measurement

“…Multidetector CT were first introduced in 1998. 24 With the introduction of these scanners, it became possible to capture the volumetric data necessary for multiplanar reformations and 3D reconstructions. 24 Since that time, the tools necessary for postprocessing have become commonplace.…”

“…24 With the introduction of these scanners, it became possible to capture the volumetric data necessary for multiplanar reformations and 3D reconstructions. 24 Since that time, the tools necessary for postprocessing have become commonplace. 22,23,[25][26][27] However, the burden of performing postprocessing, extracting the data, and interpreting it still rests with the technologist and radiologist.…”