Revolution spectral CT for urinary stone with a single/mixed composition in vivo: a large sample analysis

Abstract

Purpose

To analyze various compositions of urinary stones using revolution spectral CT (rapid kV switching dual-energy CT) in vivo.

Methods

202 patients with urinary stones underwent spectral CT before surgery. Zeff peak, overall scope and CT values were detected. Moreover, water/iodine attenuating material images were obtained. Removed stones were subjected to infrared spectroscopy after surgery. The results of infrared spectroscopy were compared with CT.

Results

28 stones (14.08%) with single composition, 165 stones with two mixed compositions (81.68%), and 9 stones with three mixed compositions (4.46%) were observed. When Zeff peaks of stones with single/mixed compositions were summarized together, 146 peaks of calcium oxalate monohydrate, 119 peaks of calcium oxalate dihydrate, 55 peaks of carbapatite, 38 peaks of urate, 16 peaks of struvite, and 11 peaks of brushite were totally observed. 93.8% of calcium oxalate monohydrate had Zeff peaks between 13.3 and 14.0. 91.6% of calcium oxalate dihydrate had peaks between 12.0 and 13.3. For carbapatite, 90.9% of stones had peaks from 14.0 to 15.0. A total of 94.8% of urate had peaks between 7.0 and 11.0. 93.8% of struvite had peaks between 11.0 and 13.0, and 90.9% of brushite had peaks between 12.0 and 14.0. Moreover, densities of urate, struvite and brushite were low density in iodine-based images and high-density in water-based images.

Conclusion

The in-vivo analysis of spectral CT in urinary stone revealed characteristics of different compositions, especially mixed compositions. An in-vivo predictive model may be constructed to distinguish stone compositions.

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References

  1. 1.

    Zeng G, Mai Z, Xia S et al (2017) Prevalence of kidney stones in China: an ultrasonography based cross-sectional study. BJU Int 120(1):109–116. https://doi.org/10.1111/bju.13828

    Article  PubMed  Google Scholar 

  2. 2.

    Mao S, Jiang H, Wu Z et al (2012) Urolithiasis: the most risk for nephrectomy in nonrenal tumor patients. J Endourol 26(10):1356–1360. https://doi.org/10.1089/end.2012.0080

    Article  PubMed  Google Scholar 

  3. 3.

    Ludwig WW, Matlaga BR (2018) Urinary stone disease: diagnosis, medical therapy, and surgical management. Med Clin North Am 102(2):265–277. https://doi.org/10.1016/j.mcna.2017.10.004

    Article  PubMed  Google Scholar 

  4. 4.

    Ye Z, Zeng G, Huan Y et al (2019) The status and characteristics of urinary stone composition in China. BUJ Int. https://doi.org/10.1111/bju.14765

    Article  Google Scholar 

  5. 5.

    Bhat A, Singh V, Bhat M, Kumar V, Bhat A (2018) Spectrum of urinary stone composition in Northwestern Rajasthan using Fourier transform infrared spectroscopy. Indian J Urol 34(2):144–148. https://doi.org/10.4103/iju.IJU_363_16

    Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Mussmann B, Hardy M, Jung H et al (2020) Can dual energy CT with fast kV-switching determine renal stone composition accurately? Acad Radiol. https://doi.org/10.1016/j.acra.2020.02.007

    Article  PubMed  Google Scholar 

  7. 7.

    Xie Y, Zhang S, Liu J, a, et al (2019) Value of CT spectral imaging in the differential diagnosis of thymoma and mediastinal lymphom. Br J Radiol 92(1095):20180598. https://doi.org/10.1259/bjr.20180598

    Article  PubMed  Google Scholar 

  8. 8.

    Goodsitt MM, Christotodoulou EG, Larson SC (2011) Accuracies of the synthesized monochromatic CT numbers and effective atomic numbers obtained with a rapid kVp switching dual energy CT scanner. Med Phys 38(4):2222–2232. https://doi.org/10.1118/1.3567509

    Article  PubMed  Google Scholar 

  9. 9.

    McCollough CH, Leng S, Yu L, Fletcher JG (2015) Dual- and Multi-energy CT: principles, technical approaches, and clinical applications. Radiology 276(3):637–653. https://doi.org/10.1148/radiol.2015142631

    Article  PubMed  PubMed Central  Google Scholar 

  10. 10.

    Nestler T, Nestler K, Neisius A et al (2019) Diagnostic accuracy of third-generation dual-source dual-energy CT: a prospective trial and protocol for clinical implementation. World J Urol 37(4):735–741. https://doi.org/10.1007/s00345-018-2430-4

    Article  PubMed  Google Scholar 

  11. 11.

    Leng S, Huang A, Cardona JM et al (2016) Dual-energy CT for quantification of urinary stone composition in mixed stones: a phantom study. Am J Roentgenol 207(2):321–329. https://doi.org/10.2214/AJR.15.15692

    Article  Google Scholar 

  12. 12.

    Si-Ping Gu, Zeng G-H, You Z-Y et al (2015) Types of renal calculi and management regimen for Chinese minimally invasive percutaneous nephrolithotomy. Indian J Surg 77:872–876. https://doi.org/10.1007/s12262-014-1043-4

    Article  Google Scholar 

  13. 13.

    Kravdal G, Helgø D, Moe MK (2015) Infrared spectroscopy is the gold standard for kidney stone analysis. Tidsskr Nor Laegeforen 135(4):313–314. https://doi.org/10.4045/tidsskr.15.0056

    Article  PubMed  Google Scholar 

  14. 14.

    Matsumoto K, Jinzaki M, Tanami Y et al (2011) Virtual monochromatic spectral imaging with fast kilovoltage switching: improved image quality as compared with that obtained with conventional 120-kVp CT. Radiology 259(1):257–262. https://doi.org/10.1148/radiol

    Article  PubMed  Google Scholar 

  15. 15.

    Ma G, Yong Yu, Duan H et al (2018) Subtraction CT angiography in head and neck with low radiation and contrast dose dual-energy spectral CT using rapid kV-switching technique. Br J Radiol 91(1086):20170631. https://doi.org/10.1259/bjr.20170631

    Article  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Kulkarni NM, Eisner BH, Pinho DF et al (2013) Determination of renal stone composition in phantom and patients using single-source dual-energy computed tomography. J Comput Assist Tomogr 37:37–45. https://doi.org/10.1097/RCT.0b013e3182720f66

    Article  PubMed  Google Scholar 

  17. 17.

    Cannella R, Shahait M, Furlan A et al (2020) Efficacy of single-source rapid kV-switching dual-energy CT for characterization of non-uric acid renal stones: a prospective ex vivo study using anthropomorphic phantom. Abdom Radiol 45(4):1092–1099. https://doi.org/10.1007/s00261-019-02164-3

    Article  Google Scholar 

  18. 18.

    Rompsaithong U, Jongjitaree K, Korpraphong P et al (2019) Characterization of renal stone composition by using fast kilovoltage switching dual-energy computed tomography compared to laboratory stone analysis: a pilot study. Abdom Radiol 44(3):1027–1032. https://doi.org/10.1007/s00261-018-1787-6

    Article  Google Scholar 

  19. 19.

    Ogawa N, Sato S, Ida K et al (2017) Evaluation of urinary stone composition and differentiation between urinary stones and phleboliths using single-source dual-energy computed tomography. Acta Med Okayama 71(2):91–96. https://doi.org/10.18926/AMO/54976

    CAS  Article  PubMed  Google Scholar 

  20. 20.

    Botsikas D, Hansen C, Stefanelli S et al (2014) Urinary stone detection and characterisation with dual-energy CT urography after furosemide intravenous injection: preliminary results. Eur Radiol 24(3):709–714. https://doi.org/10.1007/s00330-013-3033-5

    Article  PubMed  Google Scholar 

  21. 21.

    Tailly T, Larish Y, Nadeau B et al (2016) Combining mean and standard deviation of Hounsfield unit measurements from preoperative CT allows more accurate prediction of urinary stone composition than mean Hounsfield units alone. J Endourol 30(4):453–459. https://doi.org/10.1089/end.2015.0209

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We acknowledge Guangdong provincial Science and Technology Plan Project (No. 2017B030314108). We also acknowledge National Natural Science Foundation of China (No. 62071311).

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Li: Manuscript writing, Wang: Data collection, Ou: Data analysis, Huang: Data collection, Zeng: Project development, Wu: Manuscript editing.

Corresponding authors

Correspondence to Qing-Si Zeng or Wen-Qi Wu.

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Li, X., Wang, LP., Ou, LL. et al. Revolution spectral CT for urinary stone with a single/mixed composition in vivo: a large sample analysis. World J Urol (2021). https://doi.org/10.1007/s00345-021-03597-6

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Keywords

  • Computerized tomography
  • Dual energy
  • Urinary stone
  • Composition
  • In vivo