Ukrit Rompsaithong1, Kantima Jongjitaree1, Pornpim Korpraphong2, Varat Woranisarakul1, Tawatchai Taweemonkongsap1, Chaiyong Nualyong1, Ekkarin Chotikawanich3. 1. Division of Urology, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand. 2. Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. 3. Division of Urology, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand. ekkarinc@yahoo.com.
Abstract
PURPOSE: To prospectively examine the diagnostic performance of fast kilovoltage switching dual-energy computed tomography (DECT) in characterization of in vivo renal stone composition compared with postoperative stone analysis. METHODS: Consecutive consenting patients scheduled for endoscopic kidney stone surgery in a tertiary referral hospital from June 2015 to January 2016 were enrolled. Patients were preoperatively scanned with single-source, fast kilovoltage switching DECT. Stone compositions were determined regarding the effective atomic number measurements. Results of the stone compositions from DECT were compared to postoperative infrared spectroscopy stone analysis as the standard reference. RESULTS: For the 39 patients enrolled in the study, DECT was able to detect uric acid stone with sensitivity of 88.9% and specificity of 100%. There was 100% positive predictive value, 96.8% negative predictive value, and 97.4% accuracy. For non-contrast CT scan, sensitivity was 88.9%, specificity was 96.7%, positive predictive value was 88.9%, negative predictive value was 96.7%, and accuracy was 94.8%. Of the 39 samples examined, 21 (54%) were single composition, whereas 18 (46%) were combined. Single composition stones were correctly characterized by DECT in 100% (8/8) for uric acid. Whereas the result of uric acid stone containing stone discrimination in mixed composition was not so good with Zeff alone, iodine imaging can compensated this fault. CONCLUSIONS: DECT provides excellent accuracy in characterizing uric acid stone compositions. With the addition of iodine image, all of uric acid-containing stones can be determined by the DECT.
PURPOSE: To prospectively examine the diagnostic performance of fast kilovoltage switching dual-energy computed tomography (DECT) in characterization of in vivo renal stone composition compared with postoperative stone analysis. METHODS: Consecutive consenting patients scheduled for endoscopic kidney stone surgery in a tertiary referral hospital from June 2015 to January 2016 were enrolled. Patients were preoperatively scanned with single-source, fast kilovoltage switching DECT. Stone compositions were determined regarding the effective atomic number measurements. Results of the stone compositions from DECT were compared to postoperative infrared spectroscopy stone analysis as the standard reference. RESULTS: For the 39 patients enrolled in the study, DECT was able to detect uric acid stone with sensitivity of 88.9% and specificity of 100%. There was 100% positive predictive value, 96.8% negative predictive value, and 97.4% accuracy. For non-contrast CT scan, sensitivity was 88.9%, specificity was 96.7%, positive predictive value was 88.9%, negative predictive value was 96.7%, and accuracy was 94.8%. Of the 39 samples examined, 21 (54%) were single composition, whereas 18 (46%) were combined. Single composition stones were correctly characterized by DECT in 100% (8/8) for uric acid. Whereas the result of uric acid stone containing stone discrimination in mixed composition was not so good with Zeff alone, iodine imaging can compensated this fault. CONCLUSIONS: DECT provides excellent accuracy in characterizing uric acid stone compositions. With the addition of iodine image, all of uric acid-containing stones can be determined by the DECT.
Entities:
Keywords:
Dual-energy computed tomography; Infrared spectroscopy; Renal stone; Stone composition
Authors: Elisabeth Appel; Christoph Thomas; Andrea Steuwe; Benedikt M Schaarschmidt; Olga R Brook; Joel Aissa; Jörg Hennenlotter; Gerald Antoch; Johannes Boos Journal: Br J Radiol Date: 2021-10-07 Impact factor: 3.039
Authors: Lei Tang; Wuchao Li; Xianchun Zeng; Rongpin Wang; Xiushu Yang; Guangheng Luo; Qijian Chen; Lihui Wang; Bin Song Journal: Ann Transl Med Date: 2021-07