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Low-dose dual-energy CT for stone characterization: a systematic comparison of two generations of split-filter single-source and dual-source dual-energy CT

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Abstract

Purpose

To compare noise texture and accuracy to differentiate uric acid from non-uric acid urinary stones among four different single-source and dual-source DECT approaches in an ex vivo phantom study.

Methods

Thirty-two urinary stones embedded in gelatin were mounted on a Styrofoam disk and placed into a water-filled phantom. The phantom was imaged using four different DECT approaches: (A) dual-source DECT (DS-DE); (B) 1st generation split-filter single-source DECT (SF1-TB); (C) 2nd generation split-filter single-source DECT (SF2-TB) and (D) 2nd generation split-filter single-source DECT using serial acquisitions (SF2-TS). Two different radiation doses (3 mGy and 6 mGy) were used. Noise texture was compared by assessing the average spatial frequency (fav) of the normalized noise power spectrum (nNPS). ROC curves for stone classification were computed and the accuracy for different dual-energy ratio cutoffs was derived.

Results

NNPS demonstrated comparable noise texture among A, C, and D (fav-range 0.18–0.19) but finer noise texture for B (fav = 0.27). Stone classification showed an accuracy of 96.9%, 96.9%, 93.8%, 93.8% for A, B, C, D for low-dose, respectively, and 100%, 96.9%, 96.9%, 100% for routine dose. The vendor-specified cutoff for the dual-energy ratio was optimal except for the low-dose scan in D for which the accuracy was improved from 93.8 to 100% using an optimized cutoff.

Conclusion

Accuracy to differentiate uric acid from non-uric acid stones was high among four single-source and dual-source DECT approaches for low- and routine dose DECT scans. Noise texture differed only slightly for the first-generation split-filter approach.

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Availability of data and material

All data and material is freely available.

Abbreviations

SECT:

Single-energy computed tomography

DECT:

Dual-energy computed tomography

SF-DE:

Split-filter dual-energy

DS-DE:

Dual source dual-energy

SF1-TB:

1st generation split filter twin beam

SF2-TB:

2nd generation split filter twin beam

SF2-TS:

2nd generation split-filter twin spiral

ROI:

Region of interest

nNPS:

Normalized noise power spectrum

f av :

Average spatial frequency

f peak :

Peak spatial frequency

ROC:

Receiver operating characteristic

AUC:

Area under the curve

CI:

Confidence interval

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Acknowledgements

The authors thank Mrs. Sarah Euler for revising the manuscript.

Funding

No funding was provided.

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Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Dominik Nakhostin, Thomas Sartoretti, Matthias Eberhard, Hatem Alkadhi & André Euler

  2. Siemens Healthcare GmbH, An der Lände 1, 91301, Forchheim, Germany

    Bernhard Krauss

  3. Institute of Clinical Chemistry, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Daniel Müller

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  1. Dominik Nakhostin
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  2. Thomas Sartoretti
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  3. Matthias Eberhard
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  6. Hatem Alkadhi
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  7. André Euler
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Dominik Nakhostin and André Euler. Statistical analysis was done by Thomas Sartoretti. The first draft of the manuscript was written by Dominik Nakhostin and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Dominik Nakhostin.

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Conflict of interest

Bernhard Krauss is an employee of Siemens Healthcare GmbH. This author had no control over the data at any point during the study. The other authors do not have any relevant disclosures.

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Not needed because of design as phantom study.

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Not needed because of design as phantom study.

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Code will be made available upon reasonable request to the corresponding author.

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Not needed because of design as phantom study.

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Nakhostin, D., Sartoretti, T., Eberhard, M. et al. Low-dose dual-energy CT for stone characterization: a systematic comparison of two generations of split-filter single-source and dual-source dual-energy CT. Abdom Radiol 46, 2079–2089 (2021). https://doi.org/10.1007/s00261-020-02852-5

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