The efficacy of tin-filtration for computed tomography in diagnosing urolithiasis

Tan, Sarah; Badawy, Mohamed Khaldoun; Schneider, Michal; Lau, Kenneth; Low, Keat; Kutschera, P.

doi:10.1016/j.clinimag.2019.02.011

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…Both studies reported a reduction of the effective dose by up to 90%. 26,27 Despite the very low radiation doses, our radiologists rated most scans as optimal or slightly suboptimal in image quality, and only a few scans as suffering from limitations in diagnostic value, primarily due to artifacts caused by arms or foreign material within the scan range. Only one scan was rated as being non-diagnostic due to significant artifacts caused by lowered arms.…”

Section: Discussionmentioning

confidence: 99%

Do submillisievert-chest CT protocols impact diagnostic quality in suspected COVID-19 patients?

Thieß

Bressem

Adams

et al. 2022

Acta Radiologica Open

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Background During the ongoing global SARS-CoV-2 pandemic, there is a high demand for quick and reliable methods for early identification of infected patients. Due to its widespread availability, chest-CT is commonly used to detect early pulmonary manifestations and for follow-ups. Purpose This study aims to analyze image quality and reproducibility of readings of scans using low-dose chest CT protocols in patients suspected of SARS-CoV-2 infection. Materials and Methods Two radiologists retrospectively analyzed 100 low-dose chest CT scans of patients suspected of SARS-CoV-2 infection using two protocols on devices from two vendors regarding image quality based on a Likert scale. After 3 weeks, quality ratings were repeated to allow for analysis of intra-reader in addition to the inter-reader agreement. Furthermore, radiation dose and presence as well as distribution of radiological features were noted. Results The exams’ effective radiation doses were in median in the submillisievert range (median of 0.53 mSv, IQR: 0.35 mSv). While most scans were rated as being of optimal quality, 38% of scans were scored as suboptimal, yet only one scan was non-diagnostic. Inter-reader and intra-reader reliability showed almost perfect agreement with Cohen’s kappa of 0.82 and 0.87. Conclusion Overall, in this study, we present two protocols for submillisievert low-dose chest CT demonstrating appropriate or better image quality with almost perfect inter-reader and intra-reader agreement in patients suspected of SARS-CoV-2 infection.

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Section: Discussionmentioning

confidence: 99%

Do submillisievert-chest CT protocols impact diagnostic quality in suspected COVID-19 patients?

Thieß

Bressem

Adams

et al. 2022

Acta Radiologica Open

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“…Sn filter tends to attenuate lower X-ray energies from the high tube voltage and harden the spectrum. Therefore, its usage has improved spectral differentiation between the stones ( 16 , 28 ). It is known that both with and without filter can separate the urid acid from non-uric acid stones ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

“…Kidney stones such as brushite (a unique calcium phosphate stone), calcium oxalate monohydrate and cystine should be treated by pre-operative percutaneous nephrolithotripsy (PCNL) or retrograde intrarenal surgery (RIRS) ( 12 ). Dual-energy computed tomography (DECT) is a reliable method to determine kidney stone composition in vivo ( 13 – 16 ) and in vitro ( 17 – 20 ). However, results were inconsistent in terms of reliable differentiation of calcium to other compositions because confidence intervals overlapped, attenuation thresholds to define a calcium stone varied, and scanner settings and methods for chemical analysis differed markedly.…”

Section: Introductionmentioning

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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“…With the increasing number of stone disease cases and surgical interventions associated with it, urolithiasis has undermined economic growth in poor countries. Various modern and sophisticated techniques have come forth over time for the diagnosis of the disorder (Tan et al, 2019). Nevertheless, proper management of the urolithiasis remains a great challenge.…”

mentioning

confidence: 99%

Antiurolithiatic effects of pentacyclic triterpenes: The distance traveled from therapeutic aspects

Lobine

Ahmed

Aschner

et al. 2020

Drug Development Research

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Globally, approximately 12% of the population is inflicted by various types of urolithiasis. Standard treatments are available both to avert and treat urolithiasis, but with significant adverse side effects. Pentacyclic triterpenes represent a group of naturally occurring compounds which holds immense potential as therapeutic for treating kidney stone. This review aims to provide an integrative description on how pentacyclic triterpenes can effectively treat calcium oxalate urolithiasis through various mechanisms such as antioxidant, anti‐inflammatory, diuretic, and angiotensin‐converting enzyme inhibition. Some of the pentacylic triterpenes which shows promising activities include lupeol, oleanolic acid, betulin, and taraxasterol. Moreover, future perspectives in the development of pentacyclic triterpenes in formulations/drugs for urinary stone prevention are highlighted. It is anticipated that compiled information would serve as a scientific baseline to advocate further investigations on the potential of pentacyclic triterpenes in urolithiasis remediation.

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The efficacy of tin-filtration for computed tomography in diagnosing urolithiasis

Cited by 4 publications

References 20 publications

Do submillisievert-chest CT protocols impact diagnostic quality in suspected COVID-19 patients?

Do submillisievert-chest CT protocols impact diagnostic quality in suspected COVID-19 patients?

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

Antiurolithiatic effects of pentacyclic triterpenes: The distance traveled from therapeutic aspects

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