Dual energy computed tomography in diagnosis of urolithiasis: a new method for determining the chemical composition of urinary stones


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Abstract

The «gold standard» for the diagnosis and evaluation of urinary stones is native computed tomography, which allows determining stone localization and size of with high accuracy. However, this imaging technique has limited diagnostic usefulness in determining the stone chemical composition. The newly introduced method of dual-energy computed tomography, based on obtaining images at two different energy levels is highly effective in determining the composition of urinary stones. The review outlines the principles and methods of performing dual-energy computed tomography using various scanners. The authors analyze the results of using this method for diagnosing urolithiasis, determining the stone chemical composition and point out the limitations and difficulties encountered in its application.

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About the authors

A. G Martov

A.I. Burnazyan SSC FMBC of FMBA of Russia

Email: martovalex@mail.ru
Dr.Med.Sci., Prof., the Honored Physician of the Russian Federation, Head of Department of Urology and Andrology; Prof. at the Department of Endoscopic Urology, PMACPE, Head of Department of Urology, D.D. Pletnev CCH, Moscow Health Department

D. A Mazurenko

A.I. Burnazyan SSC Federal Medical Biophysical Center of FMBA of Russia

Email: uro1@inbox.ru
PhD, Associate Professor at the Department of Andrology and Urology, Deputy Head of the Urology Clinic of the European Medical Center EMC

M. M Klimkova

V.V. Veresaev City Clinical Hospital

Email: koshka_@mail.ru
Physician of the Highest Category, Head of The Department Diagnostic Imaging

V. E Sinitsyn

Treatment and Rehabilitation Center of Minzdrav of Russia

Email: info@russian-radiology.ru
Dr.Med.Sci., Professor, Head of the Center of Diagnostic Imaging, Treatment and Rehabilitation Center of Minzdrav of Russia, Head of the Course of Diagnostic Imaging and Radiation Therapy, Faculty of Fundamental Medicine, M.V. Lomonosov Moscow State University

L. A Nersisyan

A.I. Burnazyan Federal Medical Biophysical Center, FMBA of Russia

Email: nersmail@gmail.com
PhD Student at the Department of Urology and Andrology

N. K Gadzhiev

A.M. Nikiforov All-Russian Center of Emergency and Radiation Medicine of EMERCOM of Russia

Email: nariman.gadjiev@gmail.com
PhD, Urologist at the Department of Urology

References

  1. Trinchieri A. Epidemiology of urolithiasis. Arch Ital Urol Androl. 1996;68:203-249.
  2. Мартов А.Г., Пенюкова И.В., Москаленко С.А., Пенюков В.Г., Пенюков Д.В., Балыков И.С. Дистанционная ударно-волновая литотрипсия камней нижней группы чашечек почки. Урология. 2013;3:10-17
  3. Robertson W.G., Peacock M., Hodgkinson A. Dietary changes and the incidence of urinary calculi in the U.K. between 1958 and 1976. J. Chron Dis. 1979;32:469-476.
  4. Капсаргин Ф.П., Дябкин Е.В., Бережной А.Г. Современные подходы хирургического лечения мочекаменной болезни. Новости хирургии. 2013;21:101-106
  5. Worcester E.M., Coe F.L. Clinical practice. Calcium kidney stones. N. Engl J. Med. 2010;363:954-963.
  6. Kourambas J., Aslan P., Teh C.L., Mathias B.J., Preminger G.M. Role of stone analysis in metabolic evaluation and medical treatment of nephrolithiasis. J. Endourol. 2001;15:181-186.
  7. Ngo T.C., Assimos D.G. Uric acid nephrolithiasis: recent progress and future directions. Rev Urol. 2007;9:17-27.
  8. Kim S.C., Burns E.K., Lingeman J.E., Paterson R.F., McAteer J.A., Williams J.C. Jr. Cystine calculi: correlation of CT-visible structure, CT number, and stone morphology with fragmentation by shock wave lithotripsy. Urol Res. 2007;35 (6):319-324.
  9. Andrabi Y., Patino M., Das C.J., Eisner B., Sahani D.V., Kambadakone A. Advances in CT imaging for urolithiasis. Indian J. Urol. 2015;31:185-193.
  10. Gerber G.S., Brendler C.B. Evaluation of the urologic patient: History, physical examination, and urinalysis. In: Wein A.J., Kavoussi L.R., Novick A.C., Partin A.W., Peters C.A. eds. Campbell-Walsh Urology. Vol. 1. 10 ed. Philadelphia: Saunders Elsevier, 2012: 130.
  11. Bellin M.F., Renard-Penna R., Conort P., Bissery A., Meric J.B., Daudon M., Mallet A., Richard F., Grenier P. Helical CT evaluation of the chemical composition of urinary tract calculi with a discriminant analysis of CT-attenuation values and density. Eur Radiol. 2004;14(11):2134-2140.
  12. Hidas G., Eliahou R., Duvdevani M., Coulon P., Lemaitre L., Gofrit O.N., Pode D., Sosna J. Determination of renal stone composition with dualenergy CT: in vivo analysis and comparison with x-ray diffraction. Radiology. 2010;257:394-401.
  13. Thomas C., Patschan O., Ketelsen D., Tsiflikas I., Reimann A., Brodoefel H., Buchgeister M., Nagele U., Stenzl A., Claussen C., Kopp A., Heuschmid M., Schlemmer H.P. Dual-energy CT for the characterization of urinary calculi: In vitro and in vivo evaluation of a low-dose scanning protocol. Eur Radiol. 2009;19:1553-1559.
  14. Matlaga B.R., Kawamoto S., Fishman E. Dual source computed tomography: a novel technique to determine stone composition. Urology. 2008;72:1164-1168.
  15. Stolzmann P., Kozomara M., Chuck N., Müntener M., Leschka S., Scheffel H., Alkadhi H. In vivo identification of uric acid stones with dual-energy CT: diagnostic performance evaluation in patients. Abdom Imaging. 2010;35:629-635.
  16. Jepperson M.A., Thiel D.D., Cernigliaro J.G., Broderick G.A., Parker A.S., Haley W.E. Determination of ureter stent appearance on dual-energy computed tomography scan. Urology. 2012;80:986-989.
  17. Johnson T.R., Krauss B., Sedlmair M., Grasruck M., Bruder H., Morhard D., Fink C., Weckbach S., Lenhard M., Schmidt B., Flohr T., Reiser M.F., Becker C.R. Material differentiation by dual energy CT: initial experience. Eur Radiol. 2007;17:1510-1517.
  18. Mitcheson H.D., Zamenhof R.G., Bankoff M.S., Prien E.L. Determination of the chemical composition of urinary calculi by computerized tomography. J. Urol. 1983;130:814-819.
  19. Krasnicki T., Podgorski P., Guzinski M., Czarnecka A., Tupikowski K., Garcarek J., Marek Sqsiadek M. Novel clinical applications of dual energy computed tomography. Adv Clin Exp Med. 2012;21:831-841.
  20. Manglaviti G., Tresoldi S., Guerrer C.S., Di Leo G., Montanari E., Sardanelli F., Cornalba G. In vivo evaluation of the chemical composition of urinary stones using dual-energy CT. AJR Am J. Roentgenol. 2011;197(1):76-83.
  21. Wisenbaugh E.S., Paden R.G., Silva A.C., Humphreys M.R. Dual-energy vs conventional computed tomography in determining stone composition. Urology. 2014;83:1243-1247.
  22. Grosjean R., Daudon M., Chammas M.F., Jr, Claudon M., Eschwege P., Felblinger J., Hubert J. Pitfalls in urinary stone identification using CT attenuation values: are we getting the same information on different scanner models? Eur J. Radiol. 2013;82:1201-1206.
  23. Li X., Zhao R., Liu B., Yu Y. Gemstone spectral imaging dual-energy computed tomography: a novel technique to determine urinary stone composition. Urology. 2013;81 (4):727-730.
  24. Wang J., Qu M., Duan X., Takahashi N., Kawashima A., Leng S., McCollough C.H. Characterisation of urinary stones in the presence of iodinated contrast medium using dual-energy CT: a phantom study. Eur Radiol. 2012;22 (12):2589-2596.
  25. Жестовская С.И., Капсаргин Ф.П., Зуева Л.Ф., Алексеева Е.А. Определение компонентного состава конкремента с целью ранней послеоперационной метафилактики. Актуальные вопросы урологии сборник научных трудов V. Конгресса урологов Сибири с международным участием г. Красноярск. 2016:287-290
  26. Acharya S., Goyal A., Bhalla A.S. In vivo characterization of urinary calculi on dual-energy CT: going a step ahead with subdifferentiation of calcium stones. Acta Radiol. 2014;55:631-640.
  27. Spek A., Strittmatter F., Graser A., Kufer P., Stief C., Staehler M. Dual energy can accurately differentiate uric acid-containing urinary calculi from calcium stones. World J. Urol. 201634(9):1297-1302.
  28. Qu M., Jaramillo-Alvarez G., Ramirez-Giraldo J.C., Liu Y., Duan X., Wang J., Vrtiska T.J., Krambeck A.E., Lieske J., McCollough C.H. Urinary stone differentiation in patients with large body size using dual-energy dual-source computed tomography. Eur Radiol. 2013;23(5):1408-1414.
  29. Li X.H., Zhao R., Liu B., Yu Y.Q. Determination of urinary stone composition using dual-energy spectral CT: initial in vitro analysis. Clin Radiol. 2013;68:370-377.
  30. Jepperson M.A., Ibrahim El-S.H., Taylor A. Accuracy and Efficiency of Determining urinary calculi composition using dual-energy computed tomography compared with hounsfield unit measurements for practicing physicians. Urology. 2014;84:561-564.
  31. Jepperson M.A., Cernigliaro J.G., Sella D., Ibrahim E., Thiel D.D., Leng S., Haley W.E. Dual-energy CT for the evaluation of urinary calculi: image interpretation, pitfalls and stone mimics. Clin Radiol. 2013;68:е707-е714.
  32. Stolzmann P., Kozomara M., Chuck N., MüntenerM., Leschka S., Scheffel H., Alkadhi H. In vivo identification of uric acid stones with dual-energy CT: diagnostic performance evaluation in patients. Abdom Imaging. 2010;35:629-635.
  33. Primak A.N., Fletcher J.G., Vrtiska T.J., Dzyubak O.P., Lieske J.C., Jackson M.E., Williams J.C. Jr., McCollough C.H. Noninvasive differentiation of uric acid versus non-uric acid kidney stones using dual-energy CT. Acad Radiol. 2007;14:1441-1447.
  34. Sfoungaristos S., Kavouras A., Katafigiotis I., Perimenis P. Role of white blood cell and neutrophil counts in predicting spontaneous stone passage in patients with renal colic. Bju Int. 2012;110:339-345.
  35. Graser A., Johnson T.R., Hecht E.M., Becker C.R., Leidecker C., Staehler M., Stief C.G., Hildebrandt H., Godoy M.C., Finn M.E., Stepansky F., Reiser M.F., Macari M. Dual-energy CT in patients suspected of having renal masses: can virtual nonenhanced images replace true nonenhanced images? Radiology. 2009;252:433-440.
  36. Henzler T., Fink C., Schoenberg S.O., Schoepf U.J. Dual-energy CT: radiationdose aspects. AJR Am J. Roentgenol. 2012;199:16-25.
  37. Silva A.C., Morse B.G., Hara A.K., Paden R.G., Hongo N., Pavlicek W. Dualenergy (spectral) CT: applications in abdominal imaging. Radiographics. 2011;31:1031-1050.

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