Noninvasive Differentiation of Uric Acid versus Non-Uric Acid Kidney Stones Using Dual-Energy CT

Andrew N. Primak, Joel G. Fletcher, Terri J. Vrtiska, Oleksandr P. Dzyubak, John C. Lieske, Molly E. Jackson, James Williams, Cynthia H. McCollough

Research output: Contribution to journalArticle

247 Citations (Scopus)

Abstract

Rationale and Objectives: To determine the accuracy and sensitivity for dual-energy computed tomography (DECT) discrimination of uric acid (UA) stones from other (non-UA) renal stones in a commercially implemented product. Materials and Methods: Forty human renal stones comprising uric acid (n = 16), hydroxyapatite (n = 8), calcium oxalate (n = 8), and cystine (n = 8) were inserted in four porcine kidneys (10 each) and placed inside a 32-cm water tank anterior to a cadaver spine. Spiral dual-energy scans were obtained on a dual-source, 64-slice computed tomography (CT) system using a clinical protocol and automatic exposure control. Scanning was performed at two different collimations (0.6 mm and 1.2 mm) and within three phantom sizes (medium, large, and extra large) resulting in a total of six image datasets. These datasets were analyzed using the dual-energy software tool available on the CT system for both accuracy (number of stones correctly classified as either UA or non-UA) and sensitivity (for UA stones). Stone characterization was correlated with micro-CT. Results: For the medium and large phantom sizes, the DECT technique demonstrated 100% accuracy (40/40), regardless of collimation. For the extra large phantom size and the 0.6-mm collimation (resulting in the noisiest dataset), three (two cystine and one small UA) stones could not be classified (93% accuracy and 94% sensitivity). For the extra large phantom size and the 1.2-mm collimation, the dual-energy tool failed to identify two small UA stones (95% accuracy and 88% sensitivity). Conclusions: In an anthropomorphic phantom model, dual-energy CT can accurately discriminate uric acid stones from other stone types.

Original languageEnglish
Pages (from-to)1441-1447
Number of pages7
JournalAcademic Radiology
Volume14
Issue number12
DOIs
StatePublished - Dec 2007

Fingerprint

Kidney Calculi
Uric Acid
Tomography
Acids
Cystine
Kidney
Calcium Oxalate
Durapatite
Clinical Protocols
Cadaver
Spine
Swine
Software
Water
Datasets

Keywords

  • dual-energy computed tomography
  • Kidney stones
  • renal calculi
  • uric acid
  • urolithiasis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Primak, A. N., Fletcher, J. G., Vrtiska, T. J., Dzyubak, O. P., Lieske, J. C., Jackson, M. E., ... McCollough, C. H. (2007). Noninvasive Differentiation of Uric Acid versus Non-Uric Acid Kidney Stones Using Dual-Energy CT. Academic Radiology, 14(12), 1441-1447. https://doi.org/10.1016/j.acra.2007.09.016

Noninvasive Differentiation of Uric Acid versus Non-Uric Acid Kidney Stones Using Dual-Energy CT. / Primak, Andrew N.; Fletcher, Joel G.; Vrtiska, Terri J.; Dzyubak, Oleksandr P.; Lieske, John C.; Jackson, Molly E.; Williams, James; McCollough, Cynthia H.

In: Academic Radiology, Vol. 14, No. 12, 12.2007, p. 1441-1447.

Research output: Contribution to journalArticle

Primak, AN, Fletcher, JG, Vrtiska, TJ, Dzyubak, OP, Lieske, JC, Jackson, ME, Williams, J & McCollough, CH 2007, 'Noninvasive Differentiation of Uric Acid versus Non-Uric Acid Kidney Stones Using Dual-Energy CT', Academic Radiology, vol. 14, no. 12, pp. 1441-1447. https://doi.org/10.1016/j.acra.2007.09.016
Primak AN, Fletcher JG, Vrtiska TJ, Dzyubak OP, Lieske JC, Jackson ME et al. Noninvasive Differentiation of Uric Acid versus Non-Uric Acid Kidney Stones Using Dual-Energy CT. Academic Radiology. 2007 Dec;14(12):1441-1447. https://doi.org/10.1016/j.acra.2007.09.016
Primak, Andrew N. ; Fletcher, Joel G. ; Vrtiska, Terri J. ; Dzyubak, Oleksandr P. ; Lieske, John C. ; Jackson, Molly E. ; Williams, James ; McCollough, Cynthia H. / Noninvasive Differentiation of Uric Acid versus Non-Uric Acid Kidney Stones Using Dual-Energy CT. In: Academic Radiology. 2007 ; Vol. 14, No. 12. pp. 1441-1447.
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abstract = "Rationale and Objectives: To determine the accuracy and sensitivity for dual-energy computed tomography (DECT) discrimination of uric acid (UA) stones from other (non-UA) renal stones in a commercially implemented product. Materials and Methods: Forty human renal stones comprising uric acid (n = 16), hydroxyapatite (n = 8), calcium oxalate (n = 8), and cystine (n = 8) were inserted in four porcine kidneys (10 each) and placed inside a 32-cm water tank anterior to a cadaver spine. Spiral dual-energy scans were obtained on a dual-source, 64-slice computed tomography (CT) system using a clinical protocol and automatic exposure control. Scanning was performed at two different collimations (0.6 mm and 1.2 mm) and within three phantom sizes (medium, large, and extra large) resulting in a total of six image datasets. These datasets were analyzed using the dual-energy software tool available on the CT system for both accuracy (number of stones correctly classified as either UA or non-UA) and sensitivity (for UA stones). Stone characterization was correlated with micro-CT. Results: For the medium and large phantom sizes, the DECT technique demonstrated 100{\%} accuracy (40/40), regardless of collimation. For the extra large phantom size and the 0.6-mm collimation (resulting in the noisiest dataset), three (two cystine and one small UA) stones could not be classified (93{\%} accuracy and 94{\%} sensitivity). For the extra large phantom size and the 1.2-mm collimation, the dual-energy tool failed to identify two small UA stones (95{\%} accuracy and 88{\%} sensitivity). Conclusions: In an anthropomorphic phantom model, dual-energy CT can accurately discriminate uric acid stones from other stone types.",
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