Substantial radiation dose reduction with consistent image quality using a novel low-dose stone composition protocol.
Dual-energy CT
Low-dose CT
Multi-detector computed tomography
Urolithiasis
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
21
07
2019
accepted:
06
01
2020
pubmed:
30
1
2020
medline:
22
6
2021
entrez:
30
1
2020
Statut:
ppublish
Résumé
To assess a novel low-dose CT-protocol, combining a 150 kV spectral filtration unenhanced protocol (Sn150 kVp) and a stone-targeted dual-energy CT (DECT) in patients with urolithiasis. 232 (151 male, 49 ± 16.4 years) patients with urolithiasis received a low-dose non-contrast enhanced CT (NCCT) for suspected urinary stones either on a third-generation dual-source CT system (DSCT) using Sn150 kVp (n = 116, group 1), or on a second-generation DSCT (n = 116 group 2) using single energy (SE) 120 kVp. For group 1, a subsequent dual-energy CT (DECT) with a short stone-targeted scan range was performed. Objective and subjective image qualities were assessed. Radiation metrics were compared. 534 stones (group 1: n = 242 stones; group 2: n = 292 stones) were found. In group 1, all 215 stones within the stone-targeted DECT-scan range were identified. DE analysis was able to distinguish between UA and non-UA calculi in all collected stones. 11 calculi (5.12%) were labeled as uric acid (UA) while 204 (94.88%) were labeled as non-UA calculi. There was no significant difference in overall Signal-to-noise-ratio between group 1 and group 2 (p = 0.819). On subjective analysis both protocols achieved a median Likert rating of 2 (p = 0.171). Mean effective dose was significantly lower for combined Sn150 kVp and stone-targeted DECT (3.34 ± 1.84 mSv) compared to single energy 120 kVp NCCT (4.45 ± 2.89 mSv) (p < 0.001), equaling a 24.9% dose reduction. The evaluated novel low-dose stone composition protocol allows substantial radiation dose reduction with consistent high diagnostic image quality.
Identifiants
pubmed: 31993735
doi: 10.1007/s00345-020-03082-6
pii: 10.1007/s00345-020-03082-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2971-2979Références
Sanchez-Martin FM, Millan Rodriguez F, Esquena Fernandez S et al (2007) Incidence and prevalence of published studies about urolithiasis in Spain. A review. Actas Urol Esp 5:511–520
doi: 10.1016/S0210-4806(07)73675-6
Hall TC, Stephenson JA, Rangaraj A et al (2015) Imaging protocol for suspected ureteric calculi in patients presenting to the emergency department. Clin Radiol 3:243–247
doi: 10.1016/j.crad.2014.10.013
Hesse A (2005) Reliable data from diverse regions of the world exist to show that there has been a steady increase in the prevalence of urolithiasis. World J Urol 5:302–303
doi: 10.1007/s00345-005-0033-3
Turk C, Petrik A, Sarica K et al (2016) EAU guidelines on diagnosis and conservative management of urolithiasis. Eur Urol 3:468–474
doi: 10.1016/j.eururo.2015.07.040
Dale J, Gupta RT, Marin D et al (2017) Imaging advances in urolithiasis. J Endourol 7:623–629
doi: 10.1089/end.2016.0695
Kambadakone AR, Eisner BH, Catalano OA et al (2010) New and evolving concepts in the imaging and management of urolithiasis: urologists’ perspective. Radiographics 3:603–623
doi: 10.1148/rg.303095146
Wang J, Kang T, Arepalli C et al (2015) Half-dose non-contrast CT in the investigation of urolithiasis: image quality improvement with third-generation integrated circuit CT detectors. Abdom Radiol (NY) 5:1255–1262
Zhang GM, Shi B, Sun H et al (2017) High-pitch low-dose abdominopelvic CT with tin-filtration technique for detecting urinary stones. Abdom Radiol (NY) 8:2127–2134
doi: 10.1007/s00261-017-1103-x
Sung CK, Moon MH, Son H et al (2017) Standard vs. reduced-radiation-dose CT in the tracing of the ureter. Abdom Radiol (NY) 3:900–907
doi: 10.1007/s00261-016-0929-y
Heneghan JP, McGuire KA, Leder RA et al (2003) Helical CT for nephrolithiasis and ureterolithiasis: comparison of conventional and reduced radiation-dose techniques. Radiology 2:575–580
doi: 10.1148/radiol.2292021261
Liu W, Esler SJ, Kenny BJ et al (2000) Low-dose nonenhanced helical CT of renal colic: assessment of ureteric stone detection and measurement of effective dose equivalent. Radiology 1:51–54
doi: 10.1148/radiology.215.1.r00ap4051
Haubenreisser H, Meyer M, Sudarski S et al (2015) Unenhanced third-generation dual-source chest CT using a tin filter for spectral shaping at 100 kVp. Eur J Radiol 8:1608–1613
doi: 10.1016/j.ejrad.2015.04.018
Primak AN, Ramirez Giraldo JC, Liu X et al (2009) Improved dual-energy material discrimination for dual-source CT by means of additional spectral filtration. Med Phys 4:1359–1369
doi: 10.1118/1.3083567
Dewes P, Frellesen C, Scholtz JE et al (2016) Low-dose abdominal computed tomography for detection of urinary stone disease—impact of additional spectral shaping of the X-ray beam on image quality and dose parameters. Eur J Radiol 6:1058–1062
doi: 10.1016/j.ejrad.2016.03.016
Mansouri M, Aran S, Singh A et al (2015) Dual-energy computed tomography characterization of urinary calculi: basic principles, applications and concerns. Curr Probl Diagn Radiol 6:496–500
doi: 10.1067/j.cpradiol.2015.04.003
Ngo TC, Assimos DG (2007) Uric acid nephrolithiasis: recent progress and future directions. Rev Urol 1:17–27
Boll DT, Patil NA, Paulson EK et al (2009) Renal stone assessment with dual-energy multidetector CT and advanced postprocessing techniques: improved characterization of renal stone composition-pilot study. Radiology 3:813–820
doi: 10.1148/radiol.2503080545
Ascenti G, Siragusa C, Racchiusa S et al (2010) Stone-targeted dual-energy CT: a new diagnostic approach to urinary calculosis. Am J Roentgenol 4:953–958
doi: 10.2214/AJR.09.3635
Graser A, Johnson TR, Bader M et al (2008) Dual energy CT characterization of urinary calculi: initial in vitro and clinical experience. Investig Radiol 2:112–119
doi: 10.1097/RLI.0b013e318157a144
Franken A, Gevenois PA, Muylem AV et al (2018) In vivo differentiation of uric acid versus non-uric acid urinary calculi with third-generation dual-source dual-energy CT at reduced radiation dose. Am J Roentgenol 2:358–363
doi: 10.2214/AJR.17.18091
Macejko A, Okotie OT, Zhao LC et al (2009) Computed tomography-determined stone-free rates for ureteroscopy of upper-tract stones. J Endourol 3:379–382
doi: 10.1089/end.2008.0240
Deak PD, Smal Y, Kalender WA et al (2009) Multisection CT protocols: sex- and age-specific conversion factors used to determine effective dose from dose-length product. Radiology 1:158–166
Smith RC, Verga M, McCarthy S, Rosenfield AT (1996) Diagnosis of acute flank pain: value of unenhanced helical CT. Am J Roentgenol 1:97–101
doi: 10.2214/ajr.166.1.8571915
Niemann T, Kollmann T, Bongartz G et al (2008) Diagnostic performance of low-dose CT for the detection of urolithiasis: a meta-analysis. Am J Roentgenol 2:396–401
doi: 10.2214/AJR.07.3414
Chen TT, Wang C, Ferrandino MN et al (2015) Radiation exposure during the evaluation and management of nephrolithiasis. J Urol 4:878–885
doi: 10.1016/j.juro.2015.04.118
Kulkarni NM, Uppot RN, Eisner BH et al (2012) Radiation dose reduction at multidetector CT with adaptive statistical iterative reconstruction for evaluation of urolithiasis: how low can we go? Radiology 1:158–166
doi: 10.1148/radiol.12112470
Jin DH, Lamberton GR, Broome DR et al (2010) Effect of reduced radiation CT protocols on the detection of renal calculi. Radiology 1:100–107
doi: 10.1148/radiol.09090583
Spek A, Strittmatter F, Graser A et al (2016) Dual energy can accurately differentiate uric acid-containing urinary calculi from calcium stones. World J Urol 34:1297–1302
doi: 10.1007/s00345-015-1756-4
pubmed: 26749082
Kordbacheh H, Baliyan V, Singh P et al (2018) Rapid kVp switching dual-energy CT in the assessment of urolithiasis in patients with large body habitus: preliminary observations on image quality and stone characterization. Abdom Radiol (NY) 10:1007–1808
Primak AN, Fletcher JG, Vrtiska TJ et al (2007) Noninvasive differentiation of uric acid versus non-uric acid kidney stones using dual-energy CT. Acad Radiol 12:1441–1447
doi: 10.1016/j.acra.2007.09.016
Kaza RK, Ananthakrishnan L, Kambadakone A et al (2017) Update of dual-energy CT applications in the genitourinary tract. Am J Roentgenol 6:1185–1192
doi: 10.2214/AJR.16.17742
Jepperson MA, Cernigliaro JG, el Ibrahim SH et al (2015) In vivo comparison of radiation exposure of dual-energy CT versus low-dose CT versus standard CT for imaging urinary calculi. J Endourol 2:141–146
doi: 10.1089/end.2014.0026
Chaytor RJ, Rajbabu K, Jones PA, McKnight L (2016) 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 1067:20160408
doi: 10.1259/bjr.20160408
Smith-Bindman R, Aubin C, Bailitz J et al (2014) Ultrasonography versus computed tomography for suspected nephrolithiasis. N Engl J Med 12:1100–1110
doi: 10.1056/NEJMoa1404446