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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

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the accuracy of rapid kV-switching single-source dual-energy computed tomography (rsDECT) for prediction of classes of non-uric-acid stones.

Materials and methods

Non-uric-acid renal stones retrieved via percutaneous nephrolithotomy were prospectively collected between January 2017 and February 2018 in a single institution. Only stones ≥ 5 mm and with pure composition (i.e., ≥ 80% composed of one component) were included. Stone composition was determined using Fourier Transform Infrared Spectroscopy. The stones were scanned in 32-cm-wide anthropomorphic whole-body phantom using rsDECT. The effective atomic number (Zeff), the attenuation at 40 keV (HU40), 70 keV (HU70), and 140 keV (HU140) virtual monochromatic sets of images as well as the ratios between the attenuations were calculated. Values of stone classes were compared using ANOVA and Mann–Whitney U test. Receiver operating curves and area under curve (AUC) were calculated. A p value < 0.05 was considered statistically significant.

Results

The final study sample included 31 stones from 31 patients consisting of 25 (81%) calcium-based, 4 (13%) cystine, and 2 (6%) struvite pure stones. The mean size of the stones was 9.9 ± 2.4 mm. The mean Zeff of the stones was 12.01 ± 0.54 for calcium-based, 11.10 ± 0.68 for struvite, and 10.23 ± 0.75 for cystine stones (p < 0.001). Zeff had the best efficacy to separate different classes of stones. The calculated AUC was 0.947 for Zeff; 0.833 for HU40; 0.880 for HU70; and 0.893 for HU140.

Conclusion

Zeff derived from rsDECT has superior performance to HU and attenuation ratios for separation of different classes of non-uric-acid stones.

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Acknowledgements

We thank Joseph Martin, PA-C for his kind help on this project.

Funding

No funding was received for this study.

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Authors and Affiliations

  1. Division of Abdominal Imaging, Department of Radiology, University of Pittsburgh, UPMC Presbyterian, 200 Lothrop Street, Pittsburgh, PA, 15213, USA

    Roberto Cannella, Alessandro Furlan & Amir A. Borhani

  2. Section of Radiology - BiND, University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127, Palermo, Italy

    Roberto Cannella

  3. Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Mohammed Shahait & Joel D. Bigley

  4. Department of Radiology, St. Joseph’s Medical Center, Stockton, CA, USA

    Feng Zhang

  5. Department of Radiology, Palmetto Health-Health-University of South Carolina Medical Group, Columbia, SC, USA

    Timothy D. Averch

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  1. Roberto Cannella
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  4. Feng Zhang
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Correspondence to Amir A. Borhani.

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Disclosure

Alessandro Furlan: Research grant from General Electric; scientific consultant for General Electric; and book contract with Elsevier/Amirsys. Amir A. Borhani: Scientific consultant for Guebert; and consultant for Elsevier/Amirsys.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Cannella, R., Shahait, M., Furlan, A. et al. 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, 1092–1099 (2020). https://doi.org/10.1007/s00261-019-02164-3

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