Characterization of renal stone composition by using fast kilovoltage switching dual-energy computed tomography compared to laboratory stone analysis: a pilot study

Can Dual Energy CT with Fast kV-Switching Determine Renal Stone Composition Accurately?

“…In this experimental ex-vivo study using a porcine kidney, we found substantial agreement between infrared spectroscopy and DECT based characterization of renal stone type. The results are in line with previous studies performed using an older scanner model (12,22). However, we have demonstrated that accurate stone classification can be achieved using a substantially lower radiation dose opening up the possibilities for wider clinical application for renal stone screening using CT technology.…”

“…Importantly, previous authors have reported CTDIvol estimates of 19.11 mGy (23) and 10.73 mGy (22) in DECT, estimates at least 34% greater than that achieved in current study (Table 1). Our study also adds clinical legitimacy to stone diameter measurements undertaken by clinical CT as it included stones ranging in diameter from 0.88-6.22mm (mean diameter 3.5mm), whereas previous studies had a wider range including larger stone diameters (mean diameters >5mm).…”

“…Only a small number of studies have considered alternative approaches to achieving dual energy CT (e.g. sandwich detector; fast kV switching) (7,12,(22)(23)(24)(25). Importantly, studies evaluating sandwich detector technologies found low accuracy in chemical stone composition, especially at low dose (24,25).…”

Value of artificial intelligence model based on unenhanced computed tomography of urinary tract for preoperative prediction of calcium oxalate monohydrate stones in vivo

“…Ilyas et al (25) analyzed 60 stones in 53 patients and found that the sensitivity and specificity of DECT to differentiate UA and non-UA stones were both 100%, and 97.8% and 92.3% for CO and non-CO stones. Many studies have shown that DECT can distinguish UA and calcified stones in vivo, with an accuracy of up to 100%, and has potential for detection of mixed stones (26,27). However, compared with unenhanced CT, the cost of DECT equipment and examinations are more expensive, the clinical promotion is insufficient, and it cannot be carried out as an emergency program.…”

Dual-energy Computed Tomography Scan: A New Imaging Option

“…Uric acid stones may be detected with almost 100% sensitivity. 8 For other types, the sensitivity is lower, but still, the composition of non-uric acid stones (like cysteine or oxalate) can also be determined in many cases by DECT. 2 A 2013 study by Liu et al have shown that the accuracy of DECT in differentiating oxalate and hydroxyapatite urinary stones was comparable to urine analysis.…”