| Stone-targeted dual-energy CT: a new diagnostic approach to urinary calculosis. | |
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MedLine Citation:
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PMID: 20858824 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of our study was to assess a stone-targeted low-dose protocol for the detection and characterization of urinary tract stones using a dual-energy CT scanner. SUBJECTS AND METHODS: Thirty-nine patients (20 men, 19 women; age range, 22-87 years; average age, 47 years) with suspected renal colic in which ureteral stones were shown at low-dose unenhanced CT were enrolled in the study. Stone composition could be established in 24 patients, and these patients represent our study population regarding the CT characterization of stones. All examinations were performed with a preliminary low-dose unenhanced CT acquisition of the whole urinary system that was immediately followed by a limited (scanning length, 5 cm) dual-energy acquisition of the region containing the ureteral stone. Stone characterization was assessed using a dual-energy software tool available on the system. Two experienced radiologists who were blinded to the chemical composition of the stones retrospectively reviewed images and analyzed data to determine the composition of the stones. Their results were compared with the biochemical analysis results obtained by stereomicroscopy and infrared spectrometry. RESULTS: Based on in vitro-measured data, our combined protocol reduced dose by up to 50% compared with a full dual-energy acquisition; in addition, the calculated radiation doses of our protocol in patients are comparable to those of low-dose single- and dual-energy protocols. In 24 patients, 24 ureteral stones considered to be responsible for symptoms and detected at low-dose unenhanced CT were also shown at dual-energy CT. Correct chemical composition was obtained by dual-energy analysis in all 24 ureteral calculi regarding the characterization of uric acid (n = 3), calcium salt (n = 18), and combined uric acid-calcium salt (n = 3) stones. CONCLUSION: The use of dual-energy CT attenuation values made it possible to characterize all ureteral calculi, discriminating uric acid stones from calcium salt stones. The increment in radiation exposure due to contemporary scanning with two tubes at different energy levels can be substantially reduced using a limited stone-targeted dual-energy protocol. |
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Authors:
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Giorgio Ascenti; Carmelo Siragusa; Sergio Racchiusa; Isidora Ielo; Giambattista Privitera; Federica Midili; Silvio Mazziotti |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 195 ISSN: 1546-3141 ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-22 Completed Date: 2010-10-29 Revised Date: 2011-02-01 |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
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Languages: eng Pagination: 953-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiological Sciences, University of Messina, Policlinico G. Martino, 98100 Messina, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Female Humans Male Middle Aged Radiation Dosage Retrospective Studies Tomography, X-Ray Computed / methods* Ureteral Calculi / chemistry, radiography* Young Adult |
| Comments/Corrections | |
Comment In:
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Nat Rev Urol. 2011 Jan;8(1):7 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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