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

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*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1408-1414
Number of pages7
JournalEuropean Radiology
Volume23
Issue number5
DOIs
StatePublished - May 2013

Funding

This study was supported by National Institutes of Health (NIH) grant nos. DK83007 and DK59933. The authors would like to thank Lee Ellen Sundholm and Kristina Nunez for their assistance with manuscript preparation.

Keywords

  • Body size
  • CT number ratio
  • Dual-energy CT
  • Dual-source CT
  • Urinary stones

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint

Dive into the research topics of 'Urinary stone differentiation in patients with large body size using dual-energy dual-source computed tomography'. Together they form a unique fingerprint.

Cite this