In vivo identification of uric acid stones with dual-energy CT: diagnostic performance evaluation in patients

Stolzmann, Paul; Kozomara, Marko; Chuck, Natalie; Müntener, Michael; Leschka, Sebastian; Scheffel, Hans; Alkadhi, Hatem

doi:10.1007/s00261-009-9569-9

Cited by 106 publications

(60 citation statements)

References 28 publications

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“…The recent introduction of dual-source CT (DSCT) systems has re-enlivened DECT for various clinical indications [9][10][11][12][13][14][15][16][17], owing to the simultaneous data acquisition of two X-ray tube-detector systems at two different X-ray spectra.…”

Section: Discussionmentioning

confidence: 99%

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

et al. 2010

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PURPOSE: To differentiate proxy renal cystic lesions containing protein, blood, iodine contrast or saline solutions using dual-energy CT (DECT) equipped with a new tin filter technology (TFT). MATERIALS AND METHODS: 70 proxies (saline, protein, blood and contrast agent) were placed in unenhanced and contrast-enhanced kidney phantoms. DECT was performed at 80/140 kV with and without tin filtering. Two readers measured the CT attenuation values in all proxies twice. An 80/140 kV ratio was calculated. RESULTS: All intra-and interobserver agreements were excellent (r = 0.93-0.97; p < 0.001). All CT attenuation values were significantly higher in the enhanced than in the unenhanced setting (p < 0.05; average increase, 12.5 +/-3.6HU), while the ratios remained similar (each, p > 0.05). The CT attenuation of protein, blood and contrast agent solution differed significantly with tin filtering (p < 0.01-0.05). Significant differences were found between the ratios of protein and blood compared to contrast medium solution (each, p < 0.05) and between the ratios of protein and blood in both phantoms with tin filtering (each, p < 0.05). CONCLUSION: DECT allows discrimination between a proxy renal lesion containing contrast agent and lesions containing protein and blood through their different attenuation at 80 kV and 140 kV. Further discrimination between protein and blood containing proxies is possible when using a tin filter.Dual-Energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study 1 Abstract Purpose: To differentiate proxy renal cystic lesions containing protein, blood, iodine contrast or saline solutions using dual-energy CT (DECT) equipped with a new tin filter technology (TFT). Materials and Methods:70 proxies (saline, protein, blood and contrast agent) were placed in unenhanced and contrast-enhanced kidney phantoms. DECT was performed at 80/140kV with and without tin filtering. Two readers measured the CT attenuation values in all proxies twice. An 80/140kV ratio was calculated.Results: All intra-and interobserver agreements were excellent (r=0.93-0.97; p<0.001). All CT attenuation values were significantly higher in the enhanced than in the unenhanced setting (p<0.05; average increase, 12.5±3.6HU), while the ratios remained similar (each, p>0.05). The CT attenuation of protein, blood and contrast agent solution differed significantly with tin filtering (p<0.01-0.05). Significant differences were found between the ratios of protein and blood compared to contrast medium solution (each, p<0.05) and between the ratios of protein and blood in both phantoms with tin filtering (each, p<0.05). Conclusion:DECT allows discrimination between a proxy renal lesion containing contrast agent and lesions containing protein and blood through their different attenuation at 80kV and 140kV. Further discrimination between protein and blood containing proxies is possible when using a tin filter.

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Section: Discussionmentioning

confidence: 99%

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

et al. 2010

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“…[8][9][10] Single and dual-energy CT scan imaging have demonstrated promising results in differentiating uric acid from calcium stones. 7,11,12 Wisenbaugh and colleagues studied 32 renal stones in vitro. When they attempted to differentiate uric acid and non-uric acid stones, they accurately distinguished 40% and 93% of non-uric acid stones using singleenergy and dual-energy CT scans, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…7 Stolzmann and colleagues reported a sensitivity and specificity as high as 90% for the in vivo detection of uric acid stones. 11 However, the lack of standard protocols for imaging acquisition and its interpretation, and the concern with radiation exposure when performing dual-energy CT scan has limited its clinical utility. Micro-CT is another imaging exam that has been demonstrated as a useful tool to distinguish different kinds of stones, revealing the mineral composition and its morphological arrangement; 13,14 however it still not available in many centres and its applicability remains under investigation.…”

Section: Discussionmentioning

confidence: 99%

Nomogram to predict uric acid kidney stones based on patient’s age, BMI and 24-hour urine profiles: a multi-center validation

Torricelli¹,

Brown²,

Berto³

et al. 2015

CUAJ

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Introduction: We performed a multicentre validation of a nomogram to predict uric acid kidney stones in two populations. Methods: We reviewed the kidney stone database of two institutions, searching for patients with kidney stones who had stone composition analysis and 24-hour urine collection from January 2010 to December 2013. A nomogram to predict uric acid kidneys stones based on patient age, body mass index (BMI), and 24-hour urine collection was tested. Receiver-operating curves (ROC) were performed. Results: We identified 445 patients, 355 from Cleveland, United States, and 90 from Sao Paulo, Brazil. Uric acid stone formers were 7.9% and 8.9%, respectively. Uric acid patients had a significantly higher age and BMI, as well as significant lower urinary calcium than calcium stone formers in both populations. Uric acid had significantly higher total points when scored according to the nomogram. ROC curves showed an area under the curve of 0.8 for Cleveland and 0.92 for Sao Paulo. The cutoff value that provided the highest sensitivity and specificity was 179 points and 192 for Cleveland and Sao Paulo, respectively. Using 180 points as a cutoff provided a sensitivity and specificity of 87.5% and 68% for Cleveland, and 100% and 42% for Sao Paulo. Higher cutoffs were associated with higher specificity. The main limitation of this study is that only patients from high volume hospitals with uric acid or calcium stones were included. Conclusion: Predicting uric acid kidneys stone based on a nomogram, which includes only demographic data and 24-hour urine parameters, is feasible with a high degree of accuracy.

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“…Dual enerji BT, özellikle ürik asid içeren taşlarla ürik asit içermeyenleri yüksek doğruluk oranlarıyla gösterebilmek-tedir (35,36). Stolzmann ve ark.…”

Section: Bt Ile Taşların Iç Yapısının Değerlendirilmesiunclassified

“…Stolzmann ve ark. 'larının yaptığı çalışmada tetkikin ürik asit taşlarını saptamadaki hassasiyeti %89, özgüllüğü %98 olarak bildirilmiştir (36). Ürik asit taşları ağır-lıklı olarak karbon, oksijen, nitrojen gibi düşük molekül ağır-lıklı yapılar içerdiğinden düşük ve yüksek enerji X-ışınlarıyla diğer taş tiplerinden daha farklı şekilde etkileşim gösterirler.…”

Section: Bt Ile Taşların Iç Yapısının Değerlendirilmesiunclassified

Bilgisayarlı Tomografi İle Üriner Sistem Taşlarının Yapısı Tahmin Edilebilir Mi?

Kartal¹,

Çelenk²,

Onal³

et al. 2017

Endouroloji

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In vivo identification of uric acid stones with dual-energy CT: diagnostic performance evaluation in patients

Abstract: Our results indicate that DE dual-source CT permits for the accurate in vivo differentiation between UA-containing and non-UA-containing urinary stones.

Cited by 106 publications

References 28 publications

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

Nomogram to predict uric acid kidney stones based on patient’s age, BMI and 24-hour urine profiles: a multi-center validation

Bilgisayarlı Tomografi İle Üriner Sistem Taşlarının Yapısı Tahmin Edilebilir Mi?

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