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 Krambeck, John Lieske, Cynthia H. McCollough

Research output: Contribution to journalArticle

30 Citations (Scopus)

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
Externally publishedYes

Fingerprint

Urinary Calculi
Body Size
Tomography
ROC Curve
Apatites
Cystine
Oxalates
Tin
Uric Acid
Routine Diagnostic Tests
Sensitivity and Specificity
Water

Keywords

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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Qu, M., Jaramillo-Alvarez, G., Ramirez-Giraldo, J. C., Liu, Y., Duan, X., Wang, J., ... McCollough, C. H. (2013). Urinary stone differentiation in patients with large body size using dual-energy dual-source computed tomography. European Radiology, 23(5), 1408-1414. https://doi.org/10.1007/s00330-012-2727-4

Urinary stone differentiation in patients with large body size using dual-energy dual-source computed tomography. / Qu, Mingliang; Jaramillo-Alvarez, Giselle; Ramirez-Giraldo, Juan C.; Liu, Yu; Duan, Xinhui; Wang, Jia; Vrtiska, Terri J.; Krambeck, Amy; Lieske, John; McCollough, Cynthia H.

In: European Radiology, Vol. 23, No. 5, 05.2013, p. 1408-1414.

Research output: Contribution to journalArticle

Qu, M, Jaramillo-Alvarez, G, Ramirez-Giraldo, JC, Liu, Y, Duan, X, Wang, J, Vrtiska, TJ, Krambeck, A, Lieske, J & McCollough, CH 2013, 'Urinary stone differentiation in patients with large body size using dual-energy dual-source computed tomography', European Radiology, vol. 23, no. 5, pp. 1408-1414. https://doi.org/10.1007/s00330-012-2727-4
Qu, Mingliang ; Jaramillo-Alvarez, Giselle ; Ramirez-Giraldo, Juan C. ; Liu, Yu ; Duan, Xinhui ; Wang, Jia ; Vrtiska, Terri J. ; Krambeck, Amy ; Lieske, John ; McCollough, Cynthia H. / Urinary stone differentiation in patients with large body size using dual-energy dual-source computed tomography. In: European Radiology. 2013 ; Vol. 23, No. 5. pp. 1408-1414.
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title = "Urinary stone differentiation in patients with large body size using dual-energy dual-source computed tomography",
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.",
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author = "Mingliang Qu and Giselle Jaramillo-Alvarez and Ramirez-Giraldo, {Juan C.} and Yu Liu and Xinhui Duan and Jia Wang and Vrtiska, {Terri J.} and Amy Krambeck and John Lieske and McCollough, {Cynthia H.}",
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AU - Qu, Mingliang

AU - Jaramillo-Alvarez, Giselle

AU - Ramirez-Giraldo, Juan C.

AU - Liu, Yu

AU - Duan, Xinhui

AU - Wang, Jia

AU - Vrtiska, Terri J.

AU - Krambeck, Amy

AU - Lieske, John

AU - McCollough, Cynthia H.

PY - 2013/5

Y1 - 2013/5

N2 - 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.

AB - 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.

KW - Body size

KW - CT number ratio

KW - Dual-energy CT

KW - Dual-source CT

KW - Urinary stones

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