Application of uCT-scan and infrared spectroscopy for determination of urinary stone components

Abstrak. Batu kemih merupakan salah satu penyakit dengan tingkat prevalensi yang cukup tinggi di Indonesia. Pengetahuan komposisi pada kandungan batu kemih dapat membantu tenaga medis dalam melakukan justifikasi penanganan tindakan lanjut pada pasien dengan tepat.Tujuan penelitian iniadalah menentukan kandungan mineral yang terdapat pada batu kemih menggunakan metode analisa spektrum inframerah dan nilai hounsfield unit (HU) yang terdapat pada citra yang dihasilkan dari modality mCT-Scan. Hasil karakterisasi fourier transform infrared spectroscopy (FTIR) memperlihatkan kandungan mineral batu kemih terdiri dari batu kemih calcium oxlate monohydrate, uric acid, batu campuran calcium oxalate dengan phosphate dan batu campuran cystine dengan phosphate sedangkan hasil dari scanning mCT memperlihatkan adanya kandungan mineral batu kemih campuran seperti batu campuran calcium oxalate dan cystine, batu campuran calcium oxalate, struvite, dan cystine, dan batu campuran calciumoxalate dan uric acid.Dari hasil penelitian ini dapat disimpulkan bahwa kedua modaliti tersebut mampu memperlihatkan kandungan mineral batu kemih dengan baik. Hal ini terlihat adanya spektrum serapan karakteristik dari FTIR setiap sampel berbeda-beda dan dari hasil citra mCT-Scan memperlihatkan nilai HU yang bervariasi sehingga mengindikasikan kandungan mineral pada sampel batu kemih yang diamati juga memiliki jenis yang berbeda-beda. Abstract. Urinary stones are a disease with a high prevalence rate in Indonesia. Knowledge of the composition of the urinary stone is an essential part to determine suitable treatments for patients. The aim of this research is to determine the mineral contained in urinary stones using the infrared spectrum and the value of HU (hounsfield unit) from the image mCT-Scan. The results of FTIR characterization showed that the mineral content of urinary stones consisted of calcium oxlate monohydrate, uric acid, calcium oxalate and phosphate mixed stones and cystine-phosphate mixed stones. mCT-Scan results showed the mineral content of urinary stones such as calcium oxalate and cystine mixed stone, calcium oxalate, struvite, and cystine mixed stones, and calcium oxalate and uric acid mixed stones. This show that the two modalities are be able to determine the mineral content of urinary stones. It can be seen that the characteristic absorption spectrum of the FTIR for each sample is different and from the mCT-Scan image results, the HU value varies so that it indicates the mineral content of the observed urine stone sample are different.

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Efficacy of Hounsfield Unit of CT in Prediction of the Chemical Composition of Urinary Stones

QJM ◽

10.1093/qjmed/hcab110.004 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed Salah Mahmoud Ahmed Shehata ◽

Mohamed Rafik El-Halaby ◽

Ahmed Mohamed Saafan

Keyword(s):

Uric Acid ◽

Chemical Composition ◽

Calcium Phosphate ◽

Calcium Oxalate ◽

Chemical Structure ◽

Urinary Calculi ◽

Hounsfield Unit ◽

Urinary Stones ◽

The Mean ◽

Struvite Stones

Abstract Objectives to make a reliable correlation between the chemical composition of the urinary calculi and its Hounsfield unit on CT scan, upon which we can depend on it for prediction of the type of the urinary calculi. The prediction of the chemical structure of the stone would help us to reach a more efficient therapeutic and prophylactic plan. Methods A retrospective study was performed by interpretation of the preoperative CT scans for patients who were presented by urinary stones. Identification of the chemical structure of the calculi was implemented using Fourier Transform Infrared Spectroscopy (FT-IR spectroscopy). The laboratory report revealed multiple types of stones either of pure or mixed composition. Afterwards, a comparison was done between Hounsfield units of the stones and the chemical structure. Results The chemical structure of the urinary stones revealed four pure types of stones (Uric acid, Calcium Oxalate, Struvite and Cystine) and two types of mixed stones (mixed calcium oxalate+ Uric, and mixed calcium oxalate+ calcium phosphate). Uric acid stone had a mean Hounsfield Unit (HU) density of428 ± 81, which was quite less than the other stones, followed by struvite stones with density ranging about 714 ± 38. Mixed calcium oxalate stones could be differentiated from other types of stones like uric acid, pure calcium oxalate and struvite stones by the Hounsfield unit of Computed Tomography (the mean Hounsfield Unit was 886 ± 139 and 1427 ± 152 for mixed calcium oxalate + uric stone and mixed calcium oxalate + calcium phosphate stones respectively). Moreover, pure calcium oxalate stones were easily differentiated from all other stones using the mean Hounsfield density as it was 1158 ± 83. It was challenging only when it was compared to cystine stones, as they were quiet similar to HU value (997 ± 14). The variation of Hounsfield values among the previously mentioned stones, was statistically significant (p < 0.001). Conclusion The study proved that the Hounsfield Unit of CT scanning is a convenient measure to predict the chemical structure of urinary calculi.

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Spectrum of pediatric urinary stone composition in North Western India: analysis at tertiary care center

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20194974 ◽

2019 ◽

Vol 7 (11) ◽

pp. 4102

Author(s):

Rama Kishan Saran ◽

Pawan Katti ◽

Kiran Mirdha ◽

Sanya Saran ◽

Rajendra Prasad Takhar

Keyword(s):

Uric Acid ◽

Calcium Phosphate ◽

Calcium Oxalate ◽

Pediatric Patients ◽

Dietary Habits ◽

Urinary Stone ◽

Urinary Stones ◽

Stone Composition ◽

Epidemiological Characteristics ◽

North Western

Background: Pediatric urolithiasis results in significant morbidity in later life. Incidence as well as site and chemical composition of calculi varies according to the changes in socio-economic conditions over time and the subsequent changes in dietary habits leading to a marked variation in the spectrum of urinary stone composition. To evaluate the spectrum of urinary stone composition in pediatric population from North-western India.Methods: This was a prospective observational study conducted between October 2013 and February 2019 which included pediatric patients with urolithiasis. Demographic and epidemiological characteristics including age, sex, geography, religion, socio-economic status, dietary habits were recorded. The location and sizes of stones were documented. The data was collected, analyzed and presented using summary statistics.Results: A total of 163 patients with urolithiasis were enrolled, of which 86 (53%) aged between 6 and 10 years, 49 (30%) aged between 11 and 14 years and 28 (17%) were aged between 0 and 5 years. The majority of patients were male (n=134; 82.21%). The most common location of the stone was urinary bladder (n=106; 65.03%) followed by kidney (n=33; 20.25%), urethra (n=16; 9.82%) and ureter (n=8; 4.91%). The upper tract (kidney and ureter) to the lower tract (bladder and urethra) stone ratio was 1:4. Stones with mixed composition were more than pure stones (73.62% versus 26.38%). The most common composition was the mixed stone of calcium oxalate, calcium phosphate and uric acid (n=36; 22.09%) followed by mixed stone of calcium oxalate monohydrate and dihydrate with uric acid (n=29; 17.79%), calcium oxalate and uric acid (n=25, 15.34%), calcium oxalate and calcium phosphate (n=20; 12.27%). Calcium oxalate was present in 80% of the stones, followed by uric acid in 7%, struvite in 6%, cystine in 3% and calcium phosphate in 2%.Conclusions: These results suggest that the prevalence of mixed stones with calcium oxalate as the predominant chemical component in the urinary stones of pediatric patients studied.

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Time Changes in the Spectrum of Urinary Stone Composition: A Role for Climate Variations?

10.21203/rs.3.rs-41398/v2 ◽

2020 ◽

Author(s):

Alberto Trinchieri ◽

Alessandro Maletta ◽

Giovanni Simonelli ◽

Luca Boeri ◽

Elisa De Lorenzis ◽

...

Keyword(s):

Uric Acid ◽

Calcium Oxalate ◽

Calcium Oxalate Monohydrate ◽

Urinary Stone ◽

Northern Italy ◽

Urinary Stones ◽

Temperate Climate ◽

Stone Composition ◽

Statistical Institute ◽

Time Changes

Abstract Introduction: An increase of the frequency of uric acid urinary stones compared to calcium-containing ones has been recently described. This study was aimed at assessing the frequency of different types of urinary stones in the population of northern Italy in the period 2016-18 compared to 2001-2003. Materials and Methods: Analyses by infrared spectroscopy of 1007 stones endoscopically removed at two institutions in the area of Milan (Northern Italy) were retrospectively considered. Stones were classified as calcium oxalate monohydrate (COM) and dihydrate (COD), mixed uric acid/calcium oxalate (UC); uric acid (UA), struvite (ST); apatite (CAP); mixed calcium oxalate / apatite (CAPOX); others. The patients were divided into two groups: 2001-2003 and 2016-2018. The average temperature values of the region over the two time periods were obtained by the national statistical institute. Results: The average age of the 2001-2003 group (45.8+/-15.4 years) was significantly lower than the average age of the 2016-18 group (57.9+/-14.8) (0.000). M / F ratio was similar in the two groups: 119 / 69 (1:0.58) in 2001-2003 MI and 527 / 292 (1:0.55) in 2016-18 (p = 0.862). COM stones tended to more frequent in 2016-18 group than in 2001-03. COD stones were significantly more frequent in 2001-03 than in 2016-18. ST stone frequency was increased from 2001-03 to 2016-18. No increase of uric acid containing stones was observed in 2016-18. Results were confirmed after adjustment by age. Averages annual regional temperatures increased from 14° C to 15.4° C during the two observation periods. Conclusions: No increase of UA stones was observed, probably due to the limited impact of the global warming in our temperate climate.

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Effect of Climate on Time Changes in the Spectrum of Urinary Stone Composition

10.21203/rs.3.rs-41398/v1 ◽

2020 ◽

Author(s):

Alberto Trinchieri ◽

Alessandro Maletta ◽

Giovanni Simonelli ◽

Luca Boeri ◽

Elisa De Lorenzis ◽

...

Keyword(s):

Uric Acid ◽

Calcium Oxalate ◽

Calcium Oxalate Monohydrate ◽

Urinary Stone ◽

Northern Italy ◽

Urinary Stones ◽

Temperate Climate ◽

Stone Composition ◽

Average Temperature ◽

Time Changes

Abstract Background: An increase of the frequency of uric acid urinary stones compared to calcium-containing ones has been recently described. This study was aimed at assessing the frequency of different types of urinary stones in the population of northern Italy in the period 2016-18 compared to 2001-2003.Methods: Analyses by infrared spectroscopy of 1007 stones endoscopically removed at two institutions in the area of Milan (Northern Italy) were retrospectively considered. Stones were classified as calcium oxalate monohydrate (COM) and dihydrate (COD), mixed uric acid/calcium oxalate (UC); uric acid (UA), struvite (ST); apatite (CAP); mixed calcium oxalate / apatite (CAPOX); others. The patients were divided into two groups: 2001-2003 and 2016-2018. The average temperature values of the region over the two time periods were obtained by the national statistical institute.Results: The average age of the 2001-2003 group (45.8+/-15.4 years) was significantly lower than the average age of the 2016-18 group (57.9+/-14.8) (0.000). M / F ratio was similar in the two groups: 119 / 69 (1:0.58) in 2001-2003 and 527 / 292 (1:0.55) in 2016-18 (p = 0.862). COM stones tended to more frequent in 2016-18 group than in 2001-03. COD stones were significantly more frequent in 2001-03 than in 2016-18. ST stone frequency was increased from 2001-03 to 2016-18. No increase of uric acid containing stones was observed in 2016-18. Results were confirmed after adjustment by age. Averages annual regional temperatures increased from 14° C to 15.4° C during the two observation periods.Conclusions: No increase of UA stones was observed, probably due to the limited impact of the global warming in our temperate climate.

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Time changes in the spectrum of urinary stone composition: a role for climate variations?

BMC Nephrology ◽

10.1186/s12882-020-02193-x ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Alberto Trinchieri ◽

Alessandro Maletta ◽

Giovanni Simonelli ◽

Luca Boeri ◽

Elisa De Lorenzis ◽

...

Keyword(s):

Uric Acid ◽

Calcium Oxalate ◽

Calcium Oxalate Monohydrate ◽

Urinary Stone ◽

Northern Italy ◽

Urinary Stones ◽

Temperate Climate ◽

Stone Composition ◽

Statistical Institute ◽

Time Changes

Abstract Background An increase of the frequency of uric acid urinary stones compared to calcium-containing ones has been recently described. This study was aimed at assessing the frequency of different types of urinary stones in the population of northern Italy in the period 2016–18 compared to 2001–2003. Methods Analyses by infrared spectroscopy of 1007 stones endoscopically removed at two institutions in the area of Milan (Northern Italy) were retrospectively considered. Stones were classified as calcium oxalate monohydrate (COM) and dihydrate (COD), mixed uric acid/calcium oxalate (UC); uric acid (UA), struvite (ST); apatite (CAP); mixed calcium oxalate / apatite (CAPOX); others. The patients were divided into two groups: 2001–2003 and 2016–2018. The average temperature values of the region over the two time periods were obtained by the national statistical institute. Results The average age of the 2001–2003 group (45.8+/− 15.4 years) was significantly lower than the average age of the 2016–18 group (57.9+/− 14.8) (0.000). M / F ratio was similar in the two groups: 119 / 69 (1,0.58) in 2001–2003 and 527 / 292 (1,0.55) in 2016–18 (p = 0.862). COM stones tended to more frequent in 2016–18 group than in 2001–03. COD stones were significantly more frequent in 2001–03 than in 2016–18. ST stone frequency was increased from 2001 to 03 to 2016–18. No increase of uric acid containing stones was observed in 2016–18. Results were confirmed after adjustment by age. Averages annual regional temperatures increased from 14 °C to 15.4 °C during the two observation periods. Conclusions No increase of UA stones was observed, probably due to the limited impact of the global warming in our temperate climate.

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Using Computed Tomography to Predict in Vivo Stone Chemical Composition

Urologia Journal ◽

10.1177/039156030907600213 ◽

2009 ◽

Vol 76 (2) ◽

pp. 107-111

Author(s):

D. Tiscione ◽

L. Ruggera ◽

P. Beltrami ◽

M.A. Cerruto ◽

A. Cielo ◽

...

Keyword(s):

Computed Tomography ◽

Uric Acid ◽

Chemical Composition ◽

Calcium Oxalate ◽

Colorimetric Method ◽

Hounsfield Unit ◽

Urinary Stones ◽

Helical Computed Tomography ◽

Significant Difference

Objectives Several authors hypothesized the usefulness of the non-contrast helical computed tomography (NCHCT) with the determination of stone Hounsfield Unit (HU) values in order to predict urinary stone compositions. Preoperative knowledge of stone composition might be interesting in pre-operative decision-making process. The aim of this study was to evaluate the possible correlation between stone chemical composition and correspondent stone HU value in an in-vivo experience. Methods Forty patients with urinary stones were preoperatively studied with abdominal NCHCT, where stone HU values were reported. Stone chemical composition was obtained in each patient, using the colorimetric method. The HU value of each stone was compared with the correspondent chemical analysis. Results The median HU values of calcium oxalate (n=10), mixed calcium oxalate and phosphate (n=19), calcium phosphate (n=2), uric acid (n=6) and mixed uric acid and calcium oxalate (n=3) stones were 1060 HU [interquartile range (IQR) 743.75–1222.5]; 900 HU (IQR 588.5–1108.5); 774 HU (range 720–828); 371 HU (IQR 361.25–436.25) and 532 HU (range 476–626), respectively. Conclusions Our results confirmed a statistically significant difference of the HU values between calcium and pure uric acid calculi, suggesting a correlation between stone chemical composition and CT-density. Hounsfield unit

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Urine stones of different chemical composition occurrence depending on the level of uricuria

Urologicheskie vedomosti ◽

10.17816/uroved102107-113 ◽

2020 ◽

Vol 10 (2) ◽

pp. 107-113

Author(s):

Michail Y. Prosiannikov ◽

Nikolay V Anokhin ◽

Sergey A. Golovanov ◽

Olga V Konstantinova ◽

Andrey V. Sivkov ◽

...

Keyword(s):

Uric Acid ◽

Chemical Composition ◽

Calcium Oxalate ◽

Biochemical Analysis ◽

Urinary Stone ◽

Urinary Stones ◽

Acid Excretion ◽

Uric Acid Excretion ◽

Calcium Oxalate Stones ◽

Urinary Acid

Introduction. According to modern concepts one of the key links in the pathogenesis of urolithiasis is metabolic lithogenic disturbances. The study of the complex effect of many factors on the metabolism of urolithiasis patient is the basis of modern scientific research. We studied the frequency of various chemical urinary stones occurrence depending on various levels of uricuria. Materials and methods. Data from of 708 urolithiasis patients (303 men and 405 women) were analized. The results of blood and urine biochemical analysis and chemical composition of urinary stone were studied. The degree of uricuria was ranked by 10 intervals: from 0.4 to 14.8 mmol/day to assess the occurrence of different stones at various levels of uricuria. Results. The incidence of calculi consisting of uric acid also increases with increasing levels of uric acid in the urine. An increase in the level of uricuria above 3.11 mmol/day is observed to increase calcium-oxalate stones occurrence. Decrease in the prevalence of carbonatapatite and struvite stones observed at an increase of urine uric acid excretion. At high levels of uric acid excretion, we found uric acid and calcium oxalate stones most often. Conclusion. Control over the level of urinary acid excretion in urine is important in case of calcium-oxalate and uric acid urolithiasis.

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Use of non-contrast computed tomography determined urinary stone fragility in predicting the outcome of extracorporeal shockwave lithotripsy treatment: a single-center study

Journal of Fatima Jinnah Medical University ◽

10.37018/xivf1000 ◽

2020 ◽

Vol 14 (2) ◽

pp. 59-63

Author(s):

Athar Hameed ◽

Khazir Hayyat Gondal

Keyword(s):

Shock Waves ◽

Renal Stone ◽

Plain Film ◽

Renal Stones ◽

Renal Calculus ◽

Urinary Stone ◽

Stone Disease ◽

Urinary Stones ◽

Fisher Exact Test

Background: Renal stones represent a common urological pathology where standard treatment advised is ESWL in current practice. However, NCCT based determination of stone fragility may help to predict the outcome of ESWL treatment, hence optimizing its clinical use. Therefore, this study evaluated the role of NCCT determined urinary stone fragility in predicting the outcome of ESWL treatment in local clinical settings. Patients and methods: One hundred patients with single renal calculus of 0.6-2 cm in size were included. NCCT based determination of stone fragility in HU units was done for all patients. Patients were then subjected to ESWL, with a maximum of 3000 shock waves given per ESWL session. Plain film and/or ultrasonography was used to monitor ESWL treatment progress with a final NCCT evaluation at 12 weeks to determine the clearance of the calculi for each patient. Association of NCCT based stone fragility and outcome of ESWL was statistically analyzed using Fisher exact test. Results: The mean age of the patients was 37.7 ± 10.9 years with 54% being male. Decreasing stone fragility on NCCT (high = <500HU, moderate = 500-1000HU, and high = 1000HU) required more number and intensity of ESWL sessions (1-2 visits and 3000-6000 shock waves for high stone fragility group, 3-5 visits and 7000-18000 shock waves for the moderate group, and 6 visits and >18000 shock waves for low fragility group, respectively) necessary for clearance of urinary stones (p<0.001). In 98% of patients, the clearance of urinary stones was excellent. Conclusion: Renal stone patients with NCCT determined high and moderate stone fragility show an optimal response after ESWL treatment, whereas, for low fragility renal stones attenuative treatment like percutaneous nephrolithotomy and/or ureteroscopy should be considered instead of ESWL. This approach can enable patient stratification before ESWL therapy ensuring better clinical management of the renal stone disease.

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Urinary stone composition analysis and clinical characterization of 1520 patients in central China

Scientific Reports ◽

10.1038/s41598-021-85723-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Daling Zhang ◽

Songchao Li ◽

Zhengguo Zhang ◽

Ningyang Li ◽

Xiang Yuan ◽

...

Keyword(s):

Calcium Oxalate ◽

Urinary Stone ◽

Geographic Region ◽

Central China ◽

Urinary Stones ◽

Composition Analysis ◽

Stone Composition ◽

Calcium Oxalate Stones ◽

Significant Difference ◽

Lower Urinary

AbstractA total of 1520 patients with urinary stones from central China were collected and analysed by Fourier transform infrared spectroscopy between October 1, 2016 and December 31, 2019. For all patients, age, sex, comorbidities, stone location, laboratory examination and geographic region were collected. The most common stone component was calcium oxalate (77.5%), followed by calcium phosphate (8.7%), infection stone (7.6%), uric acid (UA) stone (5.3%)and cystine (0.9%). The males had more calcium oxalate stones (p < 0.001), while infection stone and cystine stones occurred more frequently in females (p < 0.001). The prevalence peak occurred at 41–60 years in both men and women. UA stones occurred frequently in patients with lower urinary pH (p < 0.001), while neutral urine or alkaline urine (p < 0.001) and urinary infection (p < 0.001) were more likely to be associated with infection stone stones. Patients with high levels of serum creatinine were more likely to develop UA stones (p < 0.001). The proportion of UA stones in diabetics was higher (p < 0.001), and the incidence of hypertension was higher in patients with UA stones (p < 0.001). Compared to the other types, more calcium oxalate stones were detected in the kidneys and ureters (p < 0.001), whereas struvite stones were more frequently observed in the lower urinary tract (p = 0.001). There was no significant difference in stone composition across the Qinling-Huaihe line in central China except UA stones, which were more frequently observed in patients south of the line (p < 0.001).

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Stone composition of renal stone formers from different global regions

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2021.3.307 ◽

2021 ◽

Vol 93 (3) ◽

pp. 307-312

Author(s):

Adam Hali´nski ◽

Kamran Hassan Bhatti ◽

Luca Boeri ◽

Jonathan Cloutier ◽

Kaloyan Davidoff ◽

...

Keyword(s):

Uric Acid ◽

Calcium Phosphate ◽

Calcium Oxalate ◽

Urinary Stones ◽

Ureteral Stones ◽

Stone Analysis ◽

Stone Composition ◽

Stone Formers ◽

Cystine Stones ◽

Struvite Stones

Objective: To study urinary stone composition patterns in different populations around the world. Materials and methods: Data were collected by reviewing charts of 1204 adult patients of 10 countries with renal or ureteral stones (> 18 years) in whom a stone analysis was done and available. Any method of stone analysis was accepted, but the methodology had to be registered. Results: In total, we observed 710 (59%) patients with calcium oxalate, 31 (1%) with calcium phosphate, 161 (13%) with mixed calcium oxalate/calcium phosphate, 15 (1%) with carbapatite, 110 (9%) with uric acid, 7 (< 1%) with urate (ammonium or sodium), 100 (9%) with mixed with uric acid/ calcium oxalate, 56 (5%) with struvite and 14 (1%) with cystine stones. Calciumcontaining stones were the most common in all countries ranging from 43 to 91%. Oxalate stones were more common than phosphate or mixed phosphate/oxalate stones in most countries except Egypt and India. The rate of uric acid containing stones ranged from 4 to 34%, being higher in Egypt, India, Pakistan, Iraq, Poland and Bulgaria. Struvite stones occurred in less than 5% in all countries except India (23%) and Pakistan (16%). Cystine stones occurred in 1% of cases. Conclusions: The frequency of different types of urinary stones varies from country to country. Calcium-containing stones are prevalent in all countries. The frequency of uric acid containing stones seems to depend mainly on climatic factors, being higher in countries with desert or tropical climates. Dietary patterns can also lead to an increase in the frequency of uric acid containing stones in association with high obesity rates. Struvite stones are decreasing in most countries due to improved health conditions.

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