Alex Nourian1, Eric Ghiraldi1, Justin I Friedlander2,3. 1. Department of Urology, Einstein Healthcare Network, 1200 Tabor Road, 3rd Floor Sley Building, Philadelphia, PA, 19141, USA. 2. Department of Urology, Einstein Healthcare Network, 1200 Tabor Road, 3rd Floor Sley Building, Philadelphia, PA, 19141, USA. friedlaj@einstein.edu. 3. Division of Urologic Oncology and Urology, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA. friedlaj@einstein.edu.
Abstract
PURPOSE OF REVIEW: Conventional CT imaging is an excellent tool for the diagnosis of nephrolithiasis however is limited in its ability to detect stone composition. Dual-energy CT (DECT) scans have demonstrated promise in overcoming this limitation. We review the current utility of DECT in nephrolithiasis. RECENT FINDINGS: DECT is superior to conventional CT in differentiating uric acid stones from non-uric acid stones, with numerous studies reporting sensitivities and specificities approaching > 95%. Dose reduction protocols incorporating low-dose CT scans are commonly used, providing significantly lower effective radiation doses compared to conventional CT. DECT remains an effective diagnostic tool in patients with large body habitus. DECT can accurately detect uric acid stones, which can help guide which stones may be suitable to medical dissolution. Further studies evaluating the effectiveness of DECT in guiding management of patients with nephrolithiasis can help to promote its widespread use.
PURPOSE OF REVIEW: Conventional CT imaging is an excellent tool for the diagnosis of nephrolithiasis however is limited in its ability to detect stone composition. Dual-energy CT (DECT) scans have demonstrated promise in overcoming this limitation. We review the current utility of DECT in nephrolithiasis. RECENT FINDINGS: DECT is superior to conventional CT in differentiating uric acid stones from non-uric acid stones, with numerous studies reporting sensitivities and specificities approaching > 95%. Dose reduction protocols incorporating low-dose CT scans are commonly used, providing significantly lower effective radiation doses compared to conventional CT. DECT remains an effective diagnostic tool in patients with large body habitus. DECT can accurately detect uric acid stones, which can help guide which stones may be suitable to medical dissolution. Further studies evaluating the effectiveness of DECT in guiding management of patients with nephrolithiasis can help to promote its widespread use.
Authors: Julius Henning Niehoff; Alexandra Fiona Carmichael; Matthias Michael Woeltjen; Jan Boriesosdick; Ingo Lopez Schmidt; Arwed Elias Michael; Nils Große Hokamp; Hansjuergen Piechota; Jan Borggrefe; Jan Robert Kroeger Journal: Tomography Date: 2022-06-23