AI Article Synopsis
- The study aims to evaluate how accurately contrast-enhanced dual-energy CT urography (DECTU) images can detect and measure urinary stones compared to traditional unenhanced images, and how well they differentiate between types of calcified stones.
- A total of 105 patients with identified urinary stones underwent DECTU, which involved capturing images at different phases and analyzing stone sizes and material densities to establish detection rates and differentiation thresholds.
- Results showed that while all stones were detected with unenhanced images, detection rates dropped significantly with DECTU images in the excretory phase, yet the detection and measurement of stones in the portal venous phase were reliable, allowing for dose reduction during imaging.
Article Abstract
Objective: To determine the accuracy of material-specific images derived from contrast-enhanced dual-energy CT urography (DECTU) in detecting and measuring urinary stones in comparison with that of unenhanced images and its utility in calcified stone differentiation.
Methods: 105 patients with 202 urinary stones (121 had confirmed composition by infrared spectroscopy) underwent triphasic (unenhanced, portal venous (VP) and excretory phase (EP)) DECTU. Material-specific images were derived in VP and EP with calcium-water, calcium-iodine and CaOxalate_Dihydrate (COD)-Hydroxyapatite (HAP) as basis material pairs. Stone number and size were recorded on unenhanced images and VP and EP material-specific images, where stone densities were also measured. Material densities of calcified stones (pure calcium oxalate [pCaO, = 34], mixed calcium oxalate [mCaO, = 14], mixed carbonate phosphate [mCaP, = 70]) were compared and thresholds for differentiating these stones were determined using receiver operating characteristic analysis.
Results: All 202 urinary stones were detected on the unenhanced, calcium (water) and calcium (iodine) images in VP. While the detection rate was significantly decreased to 58 and 64% using calcium (water) and calcium (iodine) images in EP, respectively (all < 0.001). Stone sizes measured on calcium (iodine) images in VP was similar to that of unenhanced images (10.6 10.7 mm, > 0.05). Significant differences in material densities were found among pCaO, mCaO and mCaP on COD(HAP) images with AUC of 0.72-0.74 for differentiating these stones.
Conclusion: Material-specific images in VP derived from DECTU allow reliably detecting and measuring urinary tract stones in comparison with unenhanced images and can identify calcified stones with moderate diagnostic performance to provide potential 33% dose reduction.
Advances In Knowledge: Material-specific images, especially the calcium (iodine) images in VP allow for reliable detection of urinary stones.Stone size measurement should be performed on the calcium (iodine) images in VP.Material density measurements on COD-HAP (VP) material decomposition images can be used to differentiate among pure calcium oxalate, mixed calcium oxalate and mixed carbonate phosphate stones with AUC of 0.72-0.74.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646646 | PMC |
| http://dx.doi.org/10.1259/bjr.20230337 | DOI Listing |
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