1887

n SA Journal of Radiology - determination of renal stone composition with dual-energy computed tomography : original research

Volume 18, Issue 1
  • ISSN : 1027-202X
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Abstract

Composition of renal stones influences management of patients with renal stone disease. Currently stone composition can only be analysed after stone extraction or passage, but recent introduction of dual-energy computed tomography (CT) to clinical practice has raised interest in the ability of this technology to determine composition of renal stones .


To determine renal stone composition in patients using single-source dual-energy rapid-peak kilovolt (kVp) switching CT.
Nineteen patients with renal stones for percutaneous nephrolithotomy were evaluated with single-source dual-energy computed tomography on a Discovery CT 750HD. The Gemstone Spectral Imaging (GSI) effective atomic number (Z) and attenuation at 70 keV monochromatic energy were used to predict the stone composition. Infrared spectroscopy and x-ray diffraction of stones after extraction served as the reference standard.
Two (10.5%) of the 19 stones had uric acid as major component. The other 17 (89.5%) were calcium-based stones. No statistically significant difference between the GSI Z and calculated effective atomic number (Z) for stone compounds was found. The GSI Z and attenuation could differentiate between uric acid and non-uric acid stones. No differentiation between different calcium stones could be made.
Uric acid and non-uric acid renal stones can be differentiated with single-source dual-energy . The GSI Z reflects the dominant material in polycrystalline stones.

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/content/m_sajr/18/1/EJC157975
2014-01-01
2016-12-11

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