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01-05-2013 | Urogenital

Urinary stone differentiation in patients with large body size using dual-energy dual-source computed tomography

Authors: Mingliang Qu, Giselle Jaramillo-Alvarez, Juan C. Ramirez-Giraldo, Yu Liu, Xinhui Duan, Jia Wang, Terri J. Vrtiska, Amy E. Krambeck, John Lieske, Cynthia H. McCollough

Published in: European Radiology | Issue 5/2013

Abstract

Objective

To evaluate the ability of 100/Sn140 kV (Sn, tin filter) dual-energy computed tomography (CT) to differentiate urinary stone types in a patient cohort with a wide range of body sizes.

Methods

Eighty human urinary stones were categorised into four groups (uric acid; cystine; struvite, oxalate and brushite together; and apatite) and imaged in 30–50-cm-wide water tanks using clinical 100/Sn140 kV protocols. The CT number ratio (CTR) between the low- and high-energy images was calculated. Thresholds for differentiating between stone groups were determined using receiver operating characteristics (ROC) analysis. Additionally, 86 stones from 66 patients were characterised using the size-adaptive CTR thresholds determined in the phantom study.

Results

In phantoms, the area under the ROC curve for differentiating between stone groups ranged from 0.71 to 1.00, depending on phantom size. In patients, body width ranged from 28.5 to 50.0 cm, and 79.1 % of stones were correctly characterised. Sensitivity and specificity for correctly identifying the stone category were 100 % and 100 % (group 1), 100 % and 95.3 % (group 2), 85.7 % and 60.9 % (group 3), and 52.6 % and 92.5 % (group 4).

Conclusion

Dual-energy CT can provide in vivo urinary stone characterisation for patients over a wide range of body sizes.

Key Points

• Dual-energy CT helps assessment of urinary stone composition in vivo.

• 100/Sn140 kV DECT differentiates among four stone types with 79.1 % accuracy.

• In vivo diagnostic test achievable in patients with many body sizes.

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Title: Urinary stone differentiation in patients with large body size using dual-energy dual-source computed tomography
Authors: Mingliang Qu
Giselle Jaramillo-Alvarez
Juan C. Ramirez-Giraldo
Yu Liu
Xinhui Duan
Jia Wang
Terri J. Vrtiska
Amy E. Krambeck
John Lieske
Cynthia H. McCollough
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: European Radiology / Issue 5/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2727-4

At a glance: The STEP trials

Springer Medicine

Urinary stone differentiation in patients with large body size using dual-energy dual-source computed tomography

Abstract

Objective

Methods

Results

Conclusion

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Key Points

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