Universität zu Köln

Hokamp, Nils Grosse, Salem, Johannes, Hesse, Albrecht, Holz, Jasmin Alexandra, Ritter, Manuel, Heidenreich, Axel, Maintz, David and Haneder, Stefan (2018). Low-Dose Characterization of Kidney Stones Using Spectral Detector Computed Tomography An Ex Vivo Study. Invest. Radiol., 53 (8). S. 457 - 463. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-0210

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Abstract

Objectives The aim of this study was to investigate the feasibility of kidney stone composition analysis using spectral detector computed tomography scanner (SDCT) with normal- and low-dose imaging protocols. Methods A total of 154 stones harvested from nephrolithotripsy or nephrolithotomy with a known monocrystalline composition as determined by infrared spectroscopy were examined in a nonanthropomorphic phantom on an SDCT (IQon, Philips, Best, the Netherlands). Imaging was performed with 120 kVp and (a) 40 mAs and (b) 200 mAs, resulting in a computed tomography dose index (CTDIvol) of 2 and 10 mGy, respectively. Besides conventional CT images (CIs), SDCT enables reconstruction of virtual monoenergetic images (40-200 keV). Spectral coefficient images were calculated by performing a voxel-by-voxel combination of 40 and 200 keV images (Matlab R2017b, Mathworks Inc). All stones were semiautomatically 3D-segmented on CI using a threshold-based algorithm implemented in an offline DICOM viewer. Statistical assessment was performed using Steel-Dwass method to adjust for multiple comparisons. Results Ca-phosphate (n = 22), Ca-oxalate (n = 82), cysteine (n = 20), struvite (n = 3), uric acid (n = 18), and xanthine stones (n = 9) were included in the analysis. Stone diameter ranged from 3.0 to 13.5 mm. On CI, attenuation differed significantly between calcific and noncalcific stones only (P 0.05), the spectral coefficient differed significantly between (//): Ca-oxalate//Ca-phosphate//cystine//struvite//uric acid//xanthine in 10 mGy protocol (all P 0.05). The same results were found for the 2 mGy-protocol, except that differentiation of Ca-oxalate and Ca-phosphate as well as uric acid and xanthine was not possible (P 0.05). Conclusions Spectral detector CT allows for differentiation of kidney stones using semi-automatic segmentation and advanced image post-processing, even in low-dose imaging protocols.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hokamp, Nils Grosse UNSPECIFIED UNSPECIFIED UNSPECIFIED Salem, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Hesse, Albrecht UNSPECIFIED UNSPECIFIED UNSPECIFIED Holz, Jasmin Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Ritter, Manuel UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Haneder, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-179093
DOI:	10.1097/RLI.0000000000000468
Journal or Publication Title:	Invest. Radiol.
Volume:	53
Number:	8
Page Range:	S. 457 - 463
Date:	2018
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1536-0210
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DUAL-ENERGY CT; URINARY CALCULI; URIC-ACID; MULTIDETECTOR CT; IMAGE QUALITY; RENAL STONES; IN-VITRO; DIFFERENTIATION; PHANTOM; FEASIBILITY Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17909