Urinary system imaging (dual-energy CT)
Citation, DOI & article data
Dual-energy CT has a number of clinical applications in the assessment of the urinary system particularly in the realm of artifact reduction and material composition
Renal stone composition
Renal calculi are composed of different substances such as uric acid, calcium phosphate, calcium oxalate, cystine, and brushite. Clinical management varies by stone type. Dual-energy CT uses advanced post-processing techniques to determine the composition of the calculi accurately 1-3 . For example, if a stone is predominantly made up of uric acid, patients can undergo standard urinary alkalinization rather than have an interventional procedure 4.
Pseudoenhancement of renal cysts
Virtual monoenergetic images ranging from 80 to 90 KeV created from dual energy data sets can be created to overcome beam hardening and partial volume of indeterminate renal masses. This can be performed retrospectively and act as a useful tool when assessing for pseudoenhancement of renal cysts 5,6.
- 1. Guggenberger R, Gnannt R, Hodler J et-al. Diagnostic performance of dual-energy CT for the detection of traumatic bone marrow lesions in the ankle: comparison with MR imaging. Radiology. 2012;264 (1): 164-73. doi:10.1148/radiol.12112217 - Pubmed citation
- 2. Stolzmann P, Scheffel H, Rentsch K et-al. Dual-energy computed tomography for the differentiation of uric acid stones: ex vivo performance evaluation. Urol. Res. 2008;36 (3-4): 133-8. doi:10.1007/s00240-008-0140-x - Pubmed citation
- 3. Leng S, Huang A, Cardona JM et-al. Dual-Energy CT for Quantification of Urinary Stone Composition in Mixed Stones: A Phantom Study. AJR Am J Roentgenol. 2016; 1-9. doi:10.2214/AJR.15.15692 - Pubmed citation
- 4. McAteer JA, Evan AP. The acute and long-term adverse effects of shock wave lithotripsy. Semin. Nephrol. 2008;28 (2): 200-13. doi:10.1016/j.semnephrol.2008.01.003 - Free text at pubmed - Pubmed citation
- 5. Mileto A, Nelson RC, Samei E, Jaffe TA, Paulson EK, Barina A, Choudhury KR, Wilson JM, Marin D. Impact of dual-energy multi-detector row CT with virtual monochromatic imaging on renal cyst pseudoenhancement: in vitro and in vivo study. Radiology. 272 (3): 767-76. doi:10.1148/radiol.14132856 - Pubmed
- 6. Wang ZJ, Coakley FV, Fu Y, Joe BN, Prevrhal S, Landeras LA, Webb EM, Yeh BM. Renal cyst pseudoenhancement at multidetector CT: what are the effects of number of detectors and peak tube voltage?. (2008) Radiology. 248 (3): 910-6. doi:10.1148/radiol.2482071583 - Pubmed