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Advances in CT imaging for urolithiasis.

Andrabi Y, Patino M, Das CJ, Eisner B, Sahani DV, Kambadakone A - Indian J Urol (2015 Jul-Sep)

Bottom Line: The emergence of multi-detector CT (MDCT) and technological innovations in CT such as dual-energy CT (DECT) has widened the scope of MDCT in the stone disease management from initial diagnosis to encompass treatment planning and monitoring of treatment success.DECT has been shown to enhance pre-treatment characterization of stone composition in comparison with conventional MDCT and is being increasingly used.Although CT-related radiation dose exposure remains a valid concern, the use of low-dose MDCT protocols and integration of newer iterative reconstruction algorithms into routine CT practice has resulted in a substantial decrease in ionizing radiation exposure.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Division of Abdominal Imaging and Intervention Radiology, Massachusetts General Hospital, Boston, MA, USA.

ABSTRACT
Urolithiasis is a common disease with increasing prevalence worldwide and a lifetime-estimated recurrence risk of over 50%. Imaging plays a critical role in the initial diagnosis, follow-up and urological management of urinary tract stone disease. Unenhanced helical computed tomography (CT) is highly sensitive (>95%) and specific (>96%) in the diagnosis of urolithiasis and is the imaging investigation of choice for the initial assessment of patients with suspected urolithiasis. The emergence of multi-detector CT (MDCT) and technological innovations in CT such as dual-energy CT (DECT) has widened the scope of MDCT in the stone disease management from initial diagnosis to encompass treatment planning and monitoring of treatment success. DECT has been shown to enhance pre-treatment characterization of stone composition in comparison with conventional MDCT and is being increasingly used. Although CT-related radiation dose exposure remains a valid concern, the use of low-dose MDCT protocols and integration of newer iterative reconstruction algorithms into routine CT practice has resulted in a substantial decrease in ionizing radiation exposure. In this review article, our intent is to discuss the role of MDCT in the diagnosis and post-treatment evaluation of urolithiasis and review the impact of emerging CT technologies such as dual energy in clinical practice.

No MeSH data available.


Related in: MedlinePlus

Volumetric assessment of renal stone burden. Axial non-contrast computed tomography image obtained prior to percutaneous nephrolithotomy demonstrates region of interest-based segmentation method for volume estimation
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Figure 1: Volumetric assessment of renal stone burden. Axial non-contrast computed tomography image obtained prior to percutaneous nephrolithotomy demonstrates region of interest-based segmentation method for volume estimation

Mentions: Despite the ease of using two-dimensional (2-D) measurements for estimation of stone burden, they are restricted in their ability to accurately quantify stone size for large stones with irregular contour such as stag horn calculi. Stone volumetry, a technique that allows estimation of stone volume, counteracts this limitation and allows accurate assessment of stone burden with MDCT. Different methods have been employed to determine the stone volume, including obtaining the product of three orthogonal measurements, generation of 3D volume measurements from the stone circumference data on various stone-bearing image sets and, more recently used, semi-automatic segmentation tools[181920] [Figure 1]. Stone volume, besides being a valuable tool for pre-operative planning, has also been shown to be a reliable predictor of treatment success.[1819] For example, it has been shown that using a stone volume cut-off of 700 mm3 can be used to successfully predict treatment outcome in patients undergoing SWL.[19]


Advances in CT imaging for urolithiasis.

Andrabi Y, Patino M, Das CJ, Eisner B, Sahani DV, Kambadakone A - Indian J Urol (2015 Jul-Sep)

Volumetric assessment of renal stone burden. Axial non-contrast computed tomography image obtained prior to percutaneous nephrolithotomy demonstrates region of interest-based segmentation method for volume estimation
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4495492&req=5

Figure 1: Volumetric assessment of renal stone burden. Axial non-contrast computed tomography image obtained prior to percutaneous nephrolithotomy demonstrates region of interest-based segmentation method for volume estimation
Mentions: Despite the ease of using two-dimensional (2-D) measurements for estimation of stone burden, they are restricted in their ability to accurately quantify stone size for large stones with irregular contour such as stag horn calculi. Stone volumetry, a technique that allows estimation of stone volume, counteracts this limitation and allows accurate assessment of stone burden with MDCT. Different methods have been employed to determine the stone volume, including obtaining the product of three orthogonal measurements, generation of 3D volume measurements from the stone circumference data on various stone-bearing image sets and, more recently used, semi-automatic segmentation tools[181920] [Figure 1]. Stone volume, besides being a valuable tool for pre-operative planning, has also been shown to be a reliable predictor of treatment success.[1819] For example, it has been shown that using a stone volume cut-off of 700 mm3 can be used to successfully predict treatment outcome in patients undergoing SWL.[19]

Bottom Line: The emergence of multi-detector CT (MDCT) and technological innovations in CT such as dual-energy CT (DECT) has widened the scope of MDCT in the stone disease management from initial diagnosis to encompass treatment planning and monitoring of treatment success.DECT has been shown to enhance pre-treatment characterization of stone composition in comparison with conventional MDCT and is being increasingly used.Although CT-related radiation dose exposure remains a valid concern, the use of low-dose MDCT protocols and integration of newer iterative reconstruction algorithms into routine CT practice has resulted in a substantial decrease in ionizing radiation exposure.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Division of Abdominal Imaging and Intervention Radiology, Massachusetts General Hospital, Boston, MA, USA.

ABSTRACT
Urolithiasis is a common disease with increasing prevalence worldwide and a lifetime-estimated recurrence risk of over 50%. Imaging plays a critical role in the initial diagnosis, follow-up and urological management of urinary tract stone disease. Unenhanced helical computed tomography (CT) is highly sensitive (>95%) and specific (>96%) in the diagnosis of urolithiasis and is the imaging investigation of choice for the initial assessment of patients with suspected urolithiasis. The emergence of multi-detector CT (MDCT) and technological innovations in CT such as dual-energy CT (DECT) has widened the scope of MDCT in the stone disease management from initial diagnosis to encompass treatment planning and monitoring of treatment success. DECT has been shown to enhance pre-treatment characterization of stone composition in comparison with conventional MDCT and is being increasingly used. Although CT-related radiation dose exposure remains a valid concern, the use of low-dose MDCT protocols and integration of newer iterative reconstruction algorithms into routine CT practice has resulted in a substantial decrease in ionizing radiation exposure. In this review article, our intent is to discuss the role of MDCT in the diagnosis and post-treatment evaluation of urolithiasis and review the impact of emerging CT technologies such as dual energy in clinical practice.

No MeSH data available.


Related in: MedlinePlus