1313 IMPROVED IN VIVO DETERMINATION OF URINARY STONE COMPOSITION USING DUAL ENERGY COMPUTED TOMOGRAPHY WITH ADVANCED POST-IMAGE ACQUISITION DATA PROCESSING (2010)

You have accessJournal of UrologyStone Disease: Evaluation & Medical Management1 Apr 20101313 IMPROVED IN VIVO DETERMINATION OF URINARY STONE COMPOSITION USING DUAL ENERGY COMPUTED TOMOGRAPHY WITH ADVANCED POST-IMAGE ACQUISITION DATA PROCESSING Dorit Zilberman, Michael Lipkin, Michael Ferrandino, Daniel Boll, Erik Paulson, and Glenn Preminger Dorit ZilbermanDorit Zilberman More articles by this author , Michael LipkinMichael Lipkin More articles by this author , Michael FerrandinoMichael Ferrandino More articles by this author , Daniel BollDaniel Boll More articles by this author , Erik PaulsonErik Paulson More articles by this author , and Glenn PremingerGlenn Preminger More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.898AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The characterization of urinary calculi using non-invasive 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 Multi-detector Tomography (DECT) has emerged as a technology to improve CT characterization of anatomic structures. This study aims to assess the ability of DECT with a novel post-image acquisition data processing technique to accurately discriminate between different types of urinary calculi in vivo and validate previous in vitro findings. METHODS A total of 25 patients who were to undergo ureteroscopy or percutaneous nephrolithotomy (PNL) and who had clinical indications for pre-operative CT were identified. All patients underwent DECT evaluation with the post-image acquisition data processing technique. Calculi fragments were harvested during PNL and subjected to infrared spectroscopy. Post-image acquisition data processing was used to predict stone composition. RESULTS Post-image acquisition processing allowed for identification of the various primary chemical compositions of urinary calculi: 2 brushite, 13 calcium oxalate-calcium phosphate, 2 struvite, 4 uric acid and 4 mixed type. Overall 84 stones were assessed by the radiologists, who were blinded to the results of stone composition. Statistical analysis demonstrated that this technique identified all stone compositions without obvious graphical overlap. CONCLUSIONS DECT with post-processing techniques allows for accurate discrimination among the main subtypes of urinary calculi in vivo The ability to better predict stone composition should have implications in determining the optimum clinical treatment modality for stone removal (ie endoscopy vs. SWL) from non-invasive, pre-procedure radiological assessment. Durham, NC© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e507-e508 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dorit Zilberman More articles by this author Michael Lipkin More articles by this author Michael Ferrandino More articles by this author Daniel Boll More articles by this author Erik Paulson More articles by this author Glenn Preminger More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...