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Targeted dual-energy single-source CT for characterisation of urinary calculi: experimental and clinical experience.
MedLine Citation:
PMID:  21847542     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To assess the accuracy of targeted dual-energy single-source multi-detector CT (MDCT) for characterisation of urinary calculi. METHODS: For proof of principle, 71 ex-vivo calculi underwent single-source 256-slice MDCT. Low-dose CT was performed in 154 patients with suspected urinary calculi. In 104 patients with urinary calculi targeted dual-energy imaging within one breath-hold was added. 46 patients with sufficient material for infrared-spectroscopy were analysed. Potential anatomical misregistrations between 80- and 140-kV(p)-images and HU-values were measured. DEIs (dual-energy-indices) were compared with the standard of reference. Effective doses were calculated. RESULTS: In 26 of 46 patients no misregistration was present. Mean deviations were 2.7 mm in the z-axis (16 patients) and 4.3 mm in the axial plane (10 patients). The DEIs were 0.018 ± 0.016 for uric acid (UA), 0.035 ± 0.015 for mixed UA and 0.102 ± 0.015 for calcified stones in-vitro and 0.017 ± 0.002 for UA, 0.050 ± 0.019 for mixed UA and 0.122 ± 0.024 for calcified calculi in-vivo. Significant differences were noted among calcium, mixed UA and UA stones (p < 0.05). For the low-dose examination mean effective dose was 3.11 mSv. Targed dual-energy resulted in an extra dose of 1.84 mSv (additional 59.1%). CONCLUSION: Targeted dual-energy imaging within one breath-hold is feasible for characterisation of urinary calculi using single-source MDCT allowing minimal anatomical discordance. Key Points • Targeted dual-energy single-source CT is feasible for characterizing urinary calculi • Dual Energy Index discriminates between uric-acid and non-uric-acid containing stones • It provides ancillary for decisions about stone removal or metaphylaxis.
Authors:
Matthias Eiber; Konstantin Holzapfel; Markus Frimberger; Michael Straub; Heike Schneider; Ernst J Rummeny; Martin Dobritz; Armin Huber
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-17
Journal Detail:
Title:  European radiology     Volume:  -     ISSN:  1432-1084     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Institute of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany, matthias.eiber@tum.de.
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