Dual energy computed tomography (DECT) utilizes the material change in attenuation when imaged at two different energies to determine the composition of urinary calculi as uric acid or non-uric acid. We discuss a series of case reports illustrating DECT's ability to provide immediate determination of uric acid versus non-uric acid calculi and facilitate more informed clinical decision-making. Further, these cases demonstrate a unique population of patients with ureteral stents and percutaneous nephrostomy tubes that benefit from DECT's ability to create a virtual color contrast between an indwelling device and the stone material and thereby significantly impacting patient morbidity.
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