scholarly journals Dual-Energy Multidetector Computed Tomography: A Highly Accurate Non-Invasive Tool for in Vivo Determination of Chemical Composition of Renal Calculi

2021 ◽  
Vol 28 (3) ◽  
pp. E202134
Author(s):  
Shafqat Shabir Bhawani ◽  
Majid Jehangir ◽  
Mohammad Masood ◽  
Sajjad Ahmad Dar ◽  
Sajad Nazir Syed
Keyword(s):  
Computed Tomography ◽  
Uric Acid ◽  
Chemical Composition ◽  
Chemical Analysis ◽  
Calcium Oxalate ◽  
Multidetector Computed Tomography ◽  
Renal Calculi ◽  
Dual Energy ◽  
Dual Energy Computed Tomography ◽  
Uric Acid Stones

Introduction. Computed tomography is more accurate than excretory urography in evaluation of renal stones due to its high sensitivity and temporal resolution; it permits sub-millimetric evaluation of the size and site of calculi but cannot evaluate their chemical composition. Dual-energy computed tomography allows evaluating the chemical composition of urinary calculi using simultaneous image acquisition at two different energy levels. The objective of the research was to determine renal stone composition using dual-energy multidetector computed tomography, and its correlation with post-extraction chemical analysis of stones. Materials and Methods. This prospective study was conducted in the Department of Radiodiagnosis and Imaging from September 2017 to March 2019. A total of 50 patients with urolithiasis at the age of 18-70 years were included in the study. Dual-energy computed tomography ratios of various stones were noted, and preoperative composition of calculi was given based on their colour and dual-energy computed tomography ratio. These results were compared with the post-extraction chemical analysis of stones (using Fourier infrared transform spectroscopy as the standard comparative method.) Results. The most common type of calculi in our study population was calcium oxalate stones (78%) followed by uric acid stones (12%), cystine stones (6%) and hydroxyapatite stones (4%). The dual-energy ratio of calcium oxalate, uric acid, cystine and hydroxyapatite stones ranged from 1.38-1.59, 0.94-1.08, and 1.20-1.28 and 1.52-1.57, respectively, with the mean dual-energy ratio of 1.43, 1.01, 1.25 and 1.55, respectively. Dual-energy computed tomography was found to be 100% sensitive and specific for differentiating uric acid stones from non‑uric acid stones. The sensitivity and specificity in differentiating calcium oxalate calculus from non‑calcium oxalate calculus was 97.5% and 90.9%, respectively, with 96% accuracy and kappa value of 0.883 suggesting strong agreement. Conclusions. Dual-energy computed tomography is highly sensitive and accurate in distinguishing between various types of renal calculi. It has vital role in management as uric acid calculi are amenable to drug treatment, while most of non-uric acid calculi require surgical intervention.

scholarly journals Characterization of Urinary Tract Stones with Dual Energy Computed Tomography

2017 ◽  
Vol 3 (1) ◽  
pp. 11
Author(s):  
Baidyanath Yadav ◽  
Surendra Maharjan
Keyword(s):  
Computed Tomography ◽  
Uric Acid ◽  
Calcium Oxalate ◽  
Graphical Analysis ◽  
Dual Energy ◽  
University Teaching ◽  
Ct Scanner ◽  
Dual Energy Computed Tomography ◽  
Uric Acid Stones

Introduction. Dual Energy Computed Tomography (DECT) scan can provides simple and reliable differentiation between uric acid and non-uric acid stones. The characterization of various stones was based on the dual energy ratio and x-ray attenuation or HU. Methodology. A prospective study was conducted among 101 adult patients in Tribhuvan University Teaching Hospital (TUTH), Nepal. Informed written consent was obtained from all the participants. The standard low doses CT KUB were performed in multi-slice CT scanner (Siemens Somatom Definition AS+ 128 slice) at 120 kVp and 250 mAs. When stones were detected, second dual energy scans using 80 kVp and 140 kVp were obtained focusing only on the region of stones for their characterization. After post processing and graphical analysis at Syngo Via work station, the components of the stones were identified. Statistical analysis was performed in SPSS v21.0 software.Results. Out of 101 patients, 49 (48.5%) had calcium oxalate stones, 17 (16.87%) had uric acid stones, 16 (15.8%) had hydroxyapatite, 15 (14.9%) had cystine and 4 (4%) had mixed type of stones. Dual energy ratios were ranged from 0.55-1.11 for uric acid stone, 1.12-1.24 for cystine and more than 1.24 for calcium oxalate and hydroxyapatite stones. The mean HU noted in our study were; for uric acid stones (461.12 ± 119 HU at 80 kV, 449 ± 98.5 HU at 140 kV), for cystine (870.79 ± 386 at 80 kV, 743 ± 341 at 140 kV), for calcium oxalate (1246 ± 448 at 80 kV, 915 ± 316 at 140 kV) for hydroxyapatite (1301 ± 387 at 80 kV, 896 ± 315 at 140 kV) and mixed stone had (779.25 ± 269 HU at 80 kV, 665.5 ± 252 HU at 140 kV).

scholarly journals Dual-energy computed tomography for the differentiation of uric acid stones: ex vivo performance evaluation

2008 ◽  
Vol 36 (3-4) ◽  
pp. 133-138 ◽  
Author(s):  
Paul Stolzmann ◽  
Hans Scheffel ◽  
Katharina Rentsch ◽  
Thomas Schertler ◽  
Thomas Frauenfelder ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Uric Acid ◽  
Performance Evaluation ◽  
Ex Vivo ◽  
Dual Energy ◽  
Dual Energy Computed Tomography ◽  
Uric Acid Stones

scholarly journals STUDY OF URINARY SYSTEM CALCULI IN SUDANESE USING COMPUTED TOMOGRAPHY 2018-2019

2020 ◽  
Vol 7 (10) ◽  
pp. 233-237
Author(s):  
Maha Esmeal Ahmed ◽  
Mwahib Sid Ahmed Aldosh
Keyword(s):  
Computed Tomography ◽  
Uric Acid ◽  
Chemical Composition ◽  
Renal Stone ◽  
Dual Energy ◽  
Age Group ◽  
Computed Tomography Scan ◽  
Stone Composition ◽  
Dual Energy Computed Tomography ◽  
Tomography Scan

Objective: The aim of study was to study the chemical composition of renal stone in Sudanese population using computed tomography scan. Method: This is analytic study conducted in Khartoum state hospitals in the period from November 2018 to October 2019.The problem of the study was no similar study done in Sudanese populations. The study was done in 100 patients. The data was collected from computed tomography scan to the kidneys, ureters and urinary bladder. Classified and analyzed by   statistical package for the social sciences application (SPSS). Results: The study found that most chemical composition of renal stone among Sudanese population was uric acid (0%), Cystine (26%) then Struvite (14%) and calcium (60%). The most effective age group with renal stone was (61-70) years old (36.7%) and same age group have a Struvite stone (28.3%). Furthermore, the most common age group with a cyctine renal stone were the cystine affect in the age between 50 years to 60 years old. The uric acid, Cystine, and calcium stone composition may be reliably predicted in vivo on the basis of dual-energy Computed tomography findings. In the future, a single dual-energy computed tomography examination may contribute to not only the identification but also the chemical characterization of stones in the urinary tract and it may add to the information available from non-enhanced conventional CT performed for evaluation of nephrolithiasis.

944 Dose reduced dual energy computed tomography for the differentiation of uric acid and non-uric acid stones

2012 ◽  
Vol 11 (1) ◽  
pp. e944-e944a
Author(s):  
A. Miernik ◽  
M. Schoenthaler ◽  
K. Wilhelm ◽  
G. Pache ◽  
S. Bulla
Keyword(s):  
Computed Tomography ◽  
Uric Acid ◽  
Dual Energy ◽  
Dual Energy Computed Tomography ◽  
Uric Acid Stones

Diagnostic accuracy of dual-energy computed tomography (DECT) to differentiate uric acid from non-uric acid calculi: systematic review and meta-analysis

2020 ◽  
Vol 30 (5) ◽  
pp. 2791-2801 ◽  
Author(s):  
Trevor A. McGrath ◽  
Robert A. Frank ◽  
Nicola Schieda ◽  
Brian Blew ◽  
Jean-Paul Salameh ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Uric Acid ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Dual Energy ◽  
Dual Energy Computed Tomography

scholarly journals The Clinical Impact of Accurate Cystine Calculi Characterization Using Dual-Energy Computed Tomography

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
William E. Haley ◽  
El-Sayed H. Ibrahim ◽  
Mingliang Qu ◽  
Joseph G. Cernigliaro ◽  
David S. Goldfarb ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Imaging Modality ◽  
Dual Energy ◽  
Clinical Impact ◽  
Clinical Implications ◽  
Stone Composition ◽  
Dual Energy Computed Tomography ◽  
Uric Acid Stones ◽  
Cystine Stones ◽  
Composition Standard

Dual-energy computed tomography (DECT) has recently been suggested as the imaging modality of choice for kidney stones due to its ability to provide information on stone composition. Standard postprocessing of the dual-energy images accurately identifies uric acid stones, but not other types. Cystine stones can be identified from DECT images when analyzed with advanced postprocessing. This case report describes clinical implications of accurate diagnosis of cystine stones using DECT.

scholarly journals OP0318 THE ROLE OF DUAL ENERGY COMPUTED TOMOGRAPHY (DECT) IN THE DIFFERENTIATION OF GOUT AND CALCIUM PYROPHOSPHATE DEPOSITION DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 196.2-196 ◽  
Author(s):  
D. Kravchenko ◽  
P. Karakostas ◽  
P. Brossart ◽  
C. Behning ◽  
C. Meyer ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Uric Acid ◽  
Sensitivity And Specificity ◽  
Gold Standard ◽  
Calcium Pyrophosphate ◽  
Dual Energy ◽  
Laboratory Parameters ◽  
Dual Energy Computed Tomography ◽  
Non Invasive ◽  
Calcium Pyrophosphate Deposition Disease

Background:Differentiation of gout and calcium pyrophosphate deposition disease (CPPD) is sometimes difficult as patients often present with a similar clinical picture. Arthrocentesis and subsequent polarization microscopy (PM) remains the gold standard but novel diagnostic approaches such as non-invasive dual energy computed tomography (DECT) have recently been validated for gout. Currently, limited data is available on DECT in patients with CPPD.Objectives:To analyse the diagnostic impact of DECT in gout and CPPD when compared to the gold standard of PM. We further compared the results of PM to ultrasound (US), conventional radiographs (CR), and suspected clinical diagnosis (SCD). Additionally, 15 laboratory parameters were analysed.Methods:Twenty-six patients diagnosed with gout (n = 18) or CPPD (n = 8) who received a DECT and underwent arthrocentesis were included. Two independent readers assessed colour coded, as well as 80 and 120 kV DECT images for signs of monosodium urate (MSU) crystals or CPP deposition. US and CR from the patient’s initial visit along with the SCD were also compared to PM. US examinations were performed by certified musculoskeletal ultrasound specialists. The association of up to 15 laboratory parameters such as uric acid, thyroid stimulating hormone, and C-reactive protein (CRP) with the PM results was analysed.Results:Sensitivity of DECT for gout was 67% (95% CI 0.41-0.87) with a specificity of 88% (95% CI 0.47-1.0). Concerning CPPD, the sensitivity and specificity of DECT was 63% (95% CI 0.25-0.91) and 83% (95% CI 0.59-0.96) respectively. US had the highest sensitivity of 89% (95% CI 0.65-0.99) with a specificity of 75% (95% CI 0.35-0.97) for gout, while the sensitivity and specificity for CPPD were 88% (95% CI 0.47-1.0) and 89% (95% CI 0.65-0.99) respectively. The SCD had the second highest sensitivity for gout at 78% (95% CI 0.52-0.94) with a comparable sensitivity of 63% (95% CI 0.25-0.92) for CPPD. Uric acid levels were elevated in 33% of gout patients and 25% of CPPD patients. While elevated CRP levels were observed in 59% of gout patients and in 88% of CPPD patients, none of the 15 analysed laboratory parameters were found to be significantly linked.Conclusion:DECT provides a non-invasive diagnostic tool for gout but might have a lower sensitivity than suggested by previous studies (67% vs 90%1). DECT sensitivity for CPPD was 63% (95% CI 0.25-0.91) in a sample group of eight patients. Both US and the SCD had higher sensitivities than DECT for gout and CPPD. Further studies with larger patient cohorts are needed in order to determine the diagnostic utility of DECT in CPPD.References:[1]Bongartz, Tim; Glazebrook, Katrina N.; Kavros, Steven J.; Murthy, Naveen S.; Merry, Stephen P.; Franz, Walter B. et al. (2015): Dual-energy CT for the diagnosis of gout: an accuracy and diagnostic yield study. InAnnals of the rheumatic diseases74 (6), pp. 1072–1077. DOI: 10.1136/annrheumdis-2013-205095.Disclosure of Interests:None declared

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