Dual-energy computed tomography: A reliable and established tool for In vivo differentiation of uric acid from nonuric acid renal Stones.

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  • Additional Information
    • Source:
      Publisher: published by Wolters Kluwer-Medknow for the Nigerian Postgraduate Medical College of Nigeria Country of Publication: Nigeria NLM ID: 9613595 Publication Model: Print Cited Medium: Print ISSN: 1117-1936 (Print) NLM ISO Abbreviation: Niger Postgrad Med J Subsets: MEDLINE
    • Publication Information:
      Publication: <2015- > : Mumbai : published by Wolters Kluwer-Medknow for the Nigerian Postgraduate Medical College of Nigeria
      Original Publication: Ebute Metta, Lagos, Nigeria : National Postgraduate Medical College of Nigeria, [1994-
    • Subject Terms:
      Calcium/*analysis ; Tomography, X-Ray Computed/*methods ; Uric Acid/*analysis ; Urinary Calculi/*diagnostic imaging; Absorptiometry, Photon/methods ; Humans ; Kidney Calculi ; Nigeria ; Reproducibility of Results ; Sensitivity and Specificity ; Urinary Calculi/chemistry
    • Abstract:
      Background: Dual-energy computed tomography (DECT) utilises the technique of simultaneous image acquisition of a body part at two different energy levels of the X-ray tubes. We used the DECT in this project to study its accuracy in non-invasive in vivo differentiation of uric acid (UA) calculi from non-UA calculi using the 3 rd generation dual-source computed tomography (CT) scanner.
      Materials and Methods: The DECT ratios of the various stones were noted and compared with the postextraction analysis of stones for composition. Sixty stones from 53 patients were included in the study, and their DECT results were compared with the post-extraction analysis (by infrared spectroscopy as the standard comparative method).
      Results: DECT was highly sensitive and specific in the diagnosis of various types of calculi based on their dual-energy ratio. It was found to be 100% sensitive and specific for differentiating UA stones from the non-UA stones. The DE ratio for the UA stones was found to be 0.98-1.13. Most of the stones belonged to non-UA category (85%), and only 15% were UA calculi. The sensitivity and specificity in differentiating a calcium oxalate from non-calcium oxalate calculus was 97.8% and 92.3%, respectively.
      Conclusion: DECT using the 3 rd generation CT scanners is highly sensitive in the determination of urinary calculi composition which will be very helpful to the treating surgeon in selecting the optimal modality of treatment as UA stones are amenable to medical therapy while most of the non-UA stones require surgical intervention.
      Competing Interests: There are no conflicts of interest
    • Contributed Indexing:
      Keywords: Tomography; uric acid; urolithiasis
    • Accession Number:
      268B43MJ25 (Uric Acid)
      SY7Q814VUP (Calcium)
    • Publication Date:
      Date Created: 20180421 Date Completed: 20190517 Latest Revision: 20220317
    • Publication Date:
      20221213
    • Accession Number:
      10.4103/npmj.npmj_24_18
    • Accession Number:
      29676347