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In vivo identification of uric acid stones with dual-energy CT: diagnostic performance evaluation in patients

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Abstract

Background

To prospectively investigate the in vivo diagnostic performance of dual-energy (DE) computed tomography (CT) for the differentiation between uric acid (UA)-containing and non-UA-containing urinary stones.

Methods

DE CT scans were performed in 180 patients with suspected urinary stone disease using a dual-source CT scanner in the DE mode (tube voltages 80 and 140 kV). Urinary stones were classified as UA-containing or non-UA-containing based on CT number measurements and DE software results. Sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) for the detection of UA-containing urinary stones were calculated using the crystallographic stone analysis as the reference standard.

Results

DE CT detected 110/180 patients (61%) with urinary stone disease. In 53 patients, stones were sampled. Forty-four out of 53 stones (83%) were non-UA-containing; and nine stones (17%) were UA-containing. The software automatically mapped 52/53 (98%) stones. One non-UA-containing stone (UA, 2 mm) was missed; one UA-containing stone (3 mm) was misclassified by software analysis. The sensitivity, specificity, PPV, and NPV for the detection of UA-containing stones was 89% (8/9, 95% CI: 52–100%), 98% (43/44, 95% CI: 88–100%), 89% (8/9, 95% CI: 52–100%), and 98% (43/44, 95% CI: 88–100%).

Conclusion

Our results indicate that DE dual-source CT permits for the accurate in vivo differentiation between UA-containing and non-UA-containing urinary stones.

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Acknowledgments

This research was supported by the National Center of Competence in Research, Computer Aided and Image Guided Medical Interventions of the Swiss National Science Foundation.

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Authors and Affiliations

  1. Institute of Diagnostic Radiology, University Hospital Zurich, Raemistr. 100, 8091, Zurich, Switzerland

    Paul Stolzmann, Natalie Chuck, Sebastian Leschka, Hans Scheffel & Hatem Alkadhi

  2. Department of Urology, University Hospital Zurich, Raemistr. 100, 8091, Zurich, Switzerland

    Marko Kozomara & Michael Müntener

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  1. Paul Stolzmann
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  2. Marko Kozomara
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  3. Natalie Chuck
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  4. Michael Müntener
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  5. Sebastian Leschka
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  6. Hans Scheffel
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  7. Hatem Alkadhi
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Correspondence to Paul Stolzmann.

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Stolzmann, P., Kozomara, M., Chuck, N. et al. In vivo identification of uric acid stones with dual-energy CT: diagnostic performance evaluation in patients. Abdom Imaging 35, 629–635 (2010). https://doi.org/10.1007/s00261-009-9569-9

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  • DOI: https://doi.org/10.1007/s00261-009-9569-9

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