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

Stępień, Monika; Chrzan, Robert; Gawlas, Wojciech

doi:10.5114/pjr.2018.79588

Cited by 4 publications

(3 citation statements)

References 10 publications

(17 reference statements)

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“…In our study, we followed the dual-energy attenuation ratio as follows: less than 1.1 for uric acid stones; ratios of 1.1-1.24 for cystine stones; and ratios of 1.25-2.4 for calcified stones [ 15 ]. In our study, DECT accurately differentiated uric acid stones (7 stones, representing 14%) from non-uric acid calculi (43 stones, representing 86%), which agreed with previous studies in the literature [ 10 - 14 , 16 ].…”

Section: Discussionsupporting

confidence: 92%

The role of third-generation dual-source dual-energy computed tomography in characterizing the composition of renal stones with infrared spectroscopy as the reference standard

Shalini¹,

Arunachalam²,

Varatharajaperumal³

et al. 2022

Pol J Radiol

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Purpose The aim of our study was to prospectively evaluate the role of third-generation, dual-source, dual-energy computed tomography (DECT) in the characterization of renal calculi, with ex vivo renal stone evaluation using Fourier transform infrared spectroscopy (IS) as the reference standard. Material and methods In our study 50 patients with history suggestive of renal calculi were subjected to DECT using 100 kVp and Sn150 kVp. With DECT, renal stone attenuation at low and high kVp was attained, and the attenuation ratios were measured. The result of DECT was compared with IS to identify the chemical composition of the extracted renal stones. IBM SPSS version 22 was used for statistical analysis. Results In our study, the mean attenuation ratio of the renal stone was 1.57 ± 0.25. Out of 50 patients, the stones of 39 patients were predicted as calcium-containing stones, in 4 patients as cystine stones, and in 7 as uric acid stones on DECT. In IS analysis, 43 patients had calcium-containing stones, and 7 patients had uric acid stones. The accuracy rate of DECT for detecting calcium and uric acid stones in our study were 90% and 100%, respectively. The positive predictive value for the DECT to assess the chemical composition of renal calculi was found to be 92%. Conclusions Third-generation DECT scan had 100% accuracy in differentiating uric acid stones from non-uric acid stones in our study. Because the treatment is different for different chemical compositions of stones, identification of specific chemical components is very important, and it can be accurately done by DECT.

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Section: Discussionsupporting

confidence: 92%

The role of third-generation dual-source dual-energy computed tomography in characterizing the composition of renal stones with infrared spectroscopy as the reference standard

Shalini¹,

Arunachalam²,

Varatharajaperumal³

et al. 2022

Pol J Radiol

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“…The added Sn filter is important for the non-uric acid stone subtypes due to a slight overlap between the calcium oxalate, calcium phosphate and hydroxyapatite. Presence of added filtration in the DS DE increases the spectral separation between the stones like in uric and non-uric stones ( 19 ). Without Sn filtration, the calcium oxalate and calcium phosphate could not be differentiated clearly from hydroxyapatite.…”

Section: Discussionmentioning

confidence: 99%

Pre-operative Percutaneous Nephrolithotripsy Characterisation of Kidney Stones with Second-Generation Dual-Source Dual-Energy Computed Tomography

Ali

Mahmud

Mohamad

2020

MJMS

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Background: The current clinical practice to manage kidney stone requires knowledge of the stone composition. However, it is often difficult to determine the actual stone composition before a stone is operatively removed from the patient. Dual-energy computed tomography (DECT) can predict urinary stone composition, but it is not widely adopted. The purpose of the study was to investigate the use of a second-generation DECT with tin or stannum (Sn) filter for characterising the kidney stones composition. Methods: Thirty-three kidney stones were scanned ex vivo using a dual-source (DS)DECT scanner with dual-energy (DE) mode of 80/140 kVp with and without 4 mm Sn filtration. DE ratio was calculated to determine the kidney stones composition (uric acid, calcium oxalate, calcium phosphate and cystine). The median DE ratio of the stones was compared using Wilcoxon signed rank test and the results were further correlated with semi-quantitative Fourier transform infrared (FTIR) spectroscopy analysis using Kendall’s Tau test with P < 0.05 deemed to be statistically significant. Results: Second-generation DS-DECT could significantly discriminate the stones composition with and without Sn filtration (P < 0.001). The median DE ratio of uric acid, calcium oxalate and cystine stones were significantly higher with Sn filtration than those without filtration (P < 0.05). DECT results revealed significant correlation with FTIR spectroscopy analysis (r = 0.716, P < 0.001). DECT with Sn filtration showed increased performance (100% sensitivity, 0% specificity) than those without filtration (48.5% sensitivity, 0% specificity) in the detection of the kidney stone subtypes. Conclusion: In the second-generation DECT with additional Sn filtration, DECT has shown a significant performance in characterising and discriminating the kidney stone composition. This may improve diagnostic and therapy management in kidney stones cases.

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“…If UA stones can be distinguished from non-UA stones, DECT testing may help some patients avoid unnecessary urinary tract treatment and its side effects. [5] Egyptian Journal of Physics https://ejphysics.journals.ekb.eg/…”

Section: Introductionmentioning

confidence: 99%

Characterization of Renal Stone Composition Using the Dual-Energy Technique of Computed Tomography: An in Vitro Study

et al. 2023

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The determination of the composition of different types of renal stones using dual energy computed tomography is essential for the selection of an appropriate management strategy. Examine the role of dual energy computed tomography in the in vitro characterization of renal stones and confirm the findings using an X-ray diffraction pattern and Fourier transform infrared spectroscopy. Included were forty randomly collected renal stones that underwent dual energy computed tomography for characterization of urinary calculi. insert stones in the bovine kidney model. Linear attenuation coefficients were measured. The dual energy ratio and index were calculated and used to detect the composition of renal stones. To establish the composition of renal stones, an X-ray diffraction pattern and Fourier transform infrared spectroscopy were used. Dual energy computed tomography can differentiate between uric acid (UA) and calcified stones. A dual energy ratio of 1.02 to 1.1 correctly predicted UA stones, while a ratio of 1.24 to 1.65 correctly predicted calcium-containing stones. A dual energy index between 0.00174 and 0.00918 accurately predicted UA stones, and a dual energy index between 0.0495-0.1497 accurately predicted calcium containing stones. Through the in-vitro study, dual energy computed tomography characterized 2/40 UA containing stones and characterized 38/40 calcium containing stones. The characterization of the dual-energy computed tomography renal stones proved to be extremely compatible with the X-ray diffraction pattern and Fourier transform infrared spectroscopy. This study demonstrates that dual-energy computed tomography can be employed in vitro to accurately differentiate between UA and calcified renal stones.

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

Cited by 4 publications

References 10 publications

The role of third-generation dual-source dual-energy computed tomography in characterizing the composition of renal stones with infrared spectroscopy as the reference standard

The role of third-generation dual-source dual-energy computed tomography in characterizing the composition of renal stones with infrared spectroscopy as the reference standard

Pre-operative Percutaneous Nephrolithotripsy Characterisation of Kidney Stones with Second-Generation Dual-Source Dual-Energy Computed Tomography

Characterization of Renal Stone Composition Using the Dual-Energy Technique of Computed Tomography: An in Vitro Study

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