Dual-energy computed tomography with advanced postimage acquisition data processing: improved determination of urinary stone composition.
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2010-03
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INTRODUCTION: The characterization of urinary calculi using noninvasive methods has the potential to affect clinical management. CT remains the gold standard for diagnosis of urinary calculi, but has not reliably differentiated varying stone compositions. Dual-energy CT (DECT) has emerged as a technology to improve CT characterization of anatomic structures. This study aims to assess the ability of DECT to accurately discriminate between different types of urinary calculi in an in vitro model using novel postimage acquisition data processing techniques. METHODS: Fifty urinary calculi were assessed, of which 44 had >or=60% composition of one component. DECT was performed utilizing 64-slice multidetector CT. The attenuation profiles of the lower-energy (DECT-Low) and higher-energy (DECT-High) datasets were used to investigate whether differences could be seen between different stone compositions. RESULTS: Postimage acquisition processing allowed for identification of the main different chemical compositions of urinary calculi: brushite, calcium oxalate-calcium phosphate, struvite, cystine, and uric acid. Statistical analysis demonstrated that this processing identified all stone compositions without obvious graphical overlap. CONCLUSION: Dual-energy multidetector CT with postprocessing techniques allows for accurate discrimination among the main different subtypes of urinary calculi in an in vitro model. The ability to better detect stone composition may have implications in determining the optimum clinical treatment modality for urinary calculi from noninvasive, preprocedure radiological assessment.
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Ferrandino, MN, SA Pierre, WN Simmons, EK Paulson, DM Albala and GM Preminger (2010). Dual-energy computed tomography with advanced postimage acquisition data processing: improved determination of urinary stone composition. J Endourol, 24(3). pp. 347–354. 10.1089/end.2009.0193 Retrieved from https://hdl.handle.net/10161/3382.
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Scholars@Duke
Walter Neal Simmons
Erik Karl Paulson
Research interests include (1) CT dose reduction, (2) clinical evaluation and applications of state-of-the-art imaging technology with an emphasis on computed body tomography, ultrasound, and magnetic resonance imaging, (3) imaging technology for hepatic lesion detection and characterization, (4) image guided percutaneous biopsies and interventional procedures, and (5) imaging of pancreatic pathology
Glenn Michael Preminger
- Minimally invasive management of urologic diseases
2. Minimally invasive management of renal and ureteral stones
3. Medical management of nephrolithiasis
4. Bioeffects of shock wave lithotripsy
5. Basic physics of shock wave lithotripsy
6. Intracorporeal lithotripsy for stone fragmentation
7. Minimally invasive management of urinary tract obstruction, including ureteropelvic junction obstruction and ureteral strictures
8. Enhanced imaging modalities for minimally invasive surgery
9. Digital video imaging during endoscopic surgery
10. 3-D imaging modalities for minimally invasive surgery
11. Holmium laser applications in urology
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