ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
Current issue Archive About the journal Editorial board Abstracting and indexing Contact Instructions for authors
SCImago Journal & Country Rank

vol. 83
Original paper

In vitro analysis of urinary stone composition in dual-energy computed tomography

Monika Stępień, Robert Chrzan, Wojciech Gawlas

© Pol J Radiol 2018; 83: e421-e425
Online publish date: 2018/09/10
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
Dual energy computed tomography (DECT) is a new method of computed tomography (CT) imaging, allowing the assessment of not only the object’s morphology, but also its composition. The aim of the study was to evaluate the potential of in vitro DECT evaluation of urinary stones’ chemical composition.

Material and methods
Six samples of surgically removed renal stones were scanned using DECT and analyzed by scanner vendor software. Uric acid stones were marked red and calcium stones white by the software. The real composition of the stones was finally verified using physicochemical laboratory analysis.

In 5 out of 6 samples, the composition of stones in DECT (3 samples identified as uric acid and 2 samples as calcium) was consistent with the physicochemical analysis (3 samples identified as uric acid, 1 as calcium phosphate, 1 as calcium oxalate). In DECT it was not possible to determine more precisely the type of calcium compounds (calcium phosphate vs. calcium oxalate) as established in the physicochemical analysis. In one stone identified in physicochemical analysis as uric acid, DECT detected a composite layered structure containing both uric acid and calcium compounds.

DECT allows uric acid to be distinguished from calcium urinary tract stones, which is crucial in the choice of appropriate therapy. Using the available hardware and software, it was not possible to more accurately distinguish types of calcified stones. Evaluation of the stone type in DECT may be limited in the case of mixed chemical composition.


urinary stone, dual energy computed tomography

Edvardsson V, Indridason O, Haraldsson G, et al. Temporal trends in the incidence of kidney stone disease. Kidney Int 2013; 83: 146-152.
Sułowicz W, Stompór T, Drabczyk R. Kamica nerkowa. In: Gajewski P (ed.). Interna Szczeklika 2016. Medycyna Praktyczna, Liszki 2016; 1567.
Świniarski P. Kamica nerkowa – rodzaje, objawy, leczenie. Przegląd Urologiczny 2014; 2: 13.
Koźmińska E. Kamica moczowa. In: Borkowski A (ed.). Urologia. Wydawnictwo Lekarskie PZWL, Warszawa 2015; 207-210.
Johnson TRC. Dual-energy CT: general principles. AJR Am J Roentgenol 2012; 199: S3-S8.
Dale J, Gupta Rajan T, Marin D, et al. Imaging advances in urolithiasis. J Endourol 2017; 31: 623-629.
Manglaviti G, Tresoldi S, Guerrer CS, et al. In vivo evaluation of the chemical composition of urinary stones using dual-energy CT. AJR Am J Roentgenol 2011; 197: W76-83.
Hidas G, Eliahou R, Duvdevani M, et al. Determination of renal stone composition with dual-energy CT: in vivo analysis and comparison with x-ray diffraction. Radiology 2010; 257: 394-401.
Graser A, Johnson TR, Bader M, et al. Dual energy CT characterization of urinary calculi: initial in vitro and clinical experience. Invest Radiol 2008; 43: 112-119.
Fung GS, Kawamoto S, Matlaga BR, et al. Differentiation of kidney stones using dual-energy CT with and without a tin filter. AJR Am J Roentgenol 2012; 198: 1380-1386.
Qu M, Ramirez-Giraldo JC, Leng S, et al. Dual-energy dual-source CT with additional spectral filtration can improve the differentiation of non-uric acid renal stones: an ex vivo phantom study. AJR Am J Roentgenol 2011; 196: 1279-1287.
Platt JF, Kaza RK. Renal applications of dual-energy CT. Abdom Radiol (NY) 2016; 41: 1122-1132.
Chaytor RJ, Rajbabu K, Jones PA, et al. Determining the composition of urinary tract calculi using stone-targeted dual-energy CT: evaluation of a low-dose scanning protocol in a clinical environment. Br J Radiol 2016; 89: 20160408.
Quick links
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe