Quantitative Prediction of Stone Fragility From Routine Dual Energy CT

Ex vivo proof of Feasibility

Andrea Ferrero, Juan C. Montoya, Lisa E. Vaughan, Alice E. Huang, Ian O. McKeag, Felicity T. Enders, James Williams, Cynthia H. McCollough

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Rationale and Objectives Previous studies have demonstrated a qualitative relationship between stone fragility and internal stone morphology. The goal of this study was to quantify morphologic features from dual-energy computed tomography (CT) images and assess their relationship to stone fragility. Materials and Methods Thirty-three calcified urinary stones were scanned with micro-CT. Next, they were placed within torso-shaped water phantoms and scanned with the dual-energy CT stone composition protocol in routine use at our institution. Mixed low- and high-energy images were used to measure volume, surface roughness, and 12 metrics describing internal morphology for each stone. The ratios of low- to high-energy CT numbers were also measured. Subsequent to imaging, stone fragility was measured by disintegrating each stone in a controlled ex vivo experiment using an ultrasonic lithotripter and recording the time to comminution. A multivariable linear regression model was developed to predict time to comminution. Results The average stone volume was 300 mm3 (range: 134–674 mm3). The average comminution time measured ex vivo was 32 seconds (range: 7–115 seconds). Stone volume, dual-energy CT number ratio, and surface roughness were found to have the best combined predictive ability to estimate comminution time (adjusted R2 = 0.58). The predictive ability of mixed dual-energy CT images, without use of the dual-energy CT number ratio, to estimate comminution time was slightly inferior, with an adjusted R2 of 0.54. Conclusions Dual-energy CT number ratios, volume, and morphologic metrics may provide a method for predicting stone fragility, as measured by time to comminution from ultrasonic lithotripsy.

Original languageEnglish (US)
Pages (from-to)1545-1552
Number of pages8
JournalAcademic Radiology
Volume23
Issue number12
DOIs
StatePublished - Dec 1 2016

Fingerprint

Tomography
Linear Models
Torso
Urinary Calculi
Lithotripsy
Ultrasonics
Water

Keywords

  • Kidney calculi
  • Lithotripsy
  • X-ray computed tomography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Ferrero, A., Montoya, J. C., Vaughan, L. E., Huang, A. E., McKeag, I. O., Enders, F. T., ... McCollough, C. H. (2016). Quantitative Prediction of Stone Fragility From Routine Dual Energy CT: Ex vivo proof of Feasibility. Academic Radiology, 23(12), 1545-1552. https://doi.org/10.1016/j.acra.2016.07.016

Quantitative Prediction of Stone Fragility From Routine Dual Energy CT : Ex vivo proof of Feasibility. / Ferrero, Andrea; Montoya, Juan C.; Vaughan, Lisa E.; Huang, Alice E.; McKeag, Ian O.; Enders, Felicity T.; Williams, James; McCollough, Cynthia H.

In: Academic Radiology, Vol. 23, No. 12, 01.12.2016, p. 1545-1552.

Research output: Contribution to journalArticle

Ferrero, A, Montoya, JC, Vaughan, LE, Huang, AE, McKeag, IO, Enders, FT, Williams, J & McCollough, CH 2016, 'Quantitative Prediction of Stone Fragility From Routine Dual Energy CT: Ex vivo proof of Feasibility', Academic Radiology, vol. 23, no. 12, pp. 1545-1552. https://doi.org/10.1016/j.acra.2016.07.016
Ferrero, Andrea ; Montoya, Juan C. ; Vaughan, Lisa E. ; Huang, Alice E. ; McKeag, Ian O. ; Enders, Felicity T. ; Williams, James ; McCollough, Cynthia H. / Quantitative Prediction of Stone Fragility From Routine Dual Energy CT : Ex vivo proof of Feasibility. In: Academic Radiology. 2016 ; Vol. 23, No. 12. pp. 1545-1552.
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AB - Rationale and Objectives Previous studies have demonstrated a qualitative relationship between stone fragility and internal stone morphology. The goal of this study was to quantify morphologic features from dual-energy computed tomography (CT) images and assess their relationship to stone fragility. Materials and Methods Thirty-three calcified urinary stones were scanned with micro-CT. Next, they were placed within torso-shaped water phantoms and scanned with the dual-energy CT stone composition protocol in routine use at our institution. Mixed low- and high-energy images were used to measure volume, surface roughness, and 12 metrics describing internal morphology for each stone. The ratios of low- to high-energy CT numbers were also measured. Subsequent to imaging, stone fragility was measured by disintegrating each stone in a controlled ex vivo experiment using an ultrasonic lithotripter and recording the time to comminution. A multivariable linear regression model was developed to predict time to comminution. Results The average stone volume was 300 mm3 (range: 134–674 mm3). The average comminution time measured ex vivo was 32 seconds (range: 7–115 seconds). Stone volume, dual-energy CT number ratio, and surface roughness were found to have the best combined predictive ability to estimate comminution time (adjusted R2 = 0.58). The predictive ability of mixed dual-energy CT images, without use of the dual-energy CT number ratio, to estimate comminution time was slightly inferior, with an adjusted R2 of 0.54. Conclusions Dual-energy CT number ratios, volume, and morphologic metrics may provide a method for predicting stone fragility, as measured by time to comminution from ultrasonic lithotripsy.

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