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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

Iterative reconstruction (IR) levels in computed tomography (CT) scans performed for renal stones. IR techniques decrease image noise, allowing radiation dose reduction, while image quality is preserved or even improved. High levels of IR techniques are desired for CT scans performed for renal stones. (a–c) Coronal images from different patients generated with high levels of different IR techniques, showing renal stones in the right kidney (red arrows). (a) Image reconstructed with adaptive statistical iterative reconstruction 80%; patient's weight 70 kg and CTDIvol: 3.84 mGy. (b) iDose4 L5; patient's weight 71 kg and CTDIvol: 5.66 mGy. (c) Sonogram affirmed iterative reconstruction 4; patient's weight 81 kg and CTDIvol: 8.74 mGy. Note the comparable image quality and contrast preservation among the different images, allowing the diagnosis of urolithiasis
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Figure 6: Iterative reconstruction (IR) levels in computed tomography (CT) scans performed for renal stones. IR techniques decrease image noise, allowing radiation dose reduction, while image quality is preserved or even improved. High levels of IR techniques are desired for CT scans performed for renal stones. (a–c) Coronal images from different patients generated with high levels of different IR techniques, showing renal stones in the right kidney (red arrows). (a) Image reconstructed with adaptive statistical iterative reconstruction 80%; patient's weight 70 kg and CTDIvol: 3.84 mGy. (b) iDose4 L5; patient's weight 71 kg and CTDIvol: 5.66 mGy. (c) Sonogram affirmed iterative reconstruction 4; patient's weight 81 kg and CTDIvol: 8.74 mGy. Note the comparable image quality and contrast preservation among the different images, allowing the diagnosis of urolithiasis

Mentions: Introduction of iterative reconstructions such as adaptive statistical iterative reconstruction and sonogram affirmed iterative reconstruction allows substantial reduction in radiation exposure while preserving image quality. Several studies have shown the benefit of statistical-based IR reconstructions in CT for urolithiasis, allowing a considerable reduction in radiation dose [Figures 5 and 6].[497778798081]


Advances in CT imaging for urolithiasis.

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

Iterative reconstruction (IR) levels in computed tomography (CT) scans performed for renal stones. IR techniques decrease image noise, allowing radiation dose reduction, while image quality is preserved or even improved. High levels of IR techniques are desired for CT scans performed for renal stones. (a–c) Coronal images from different patients generated with high levels of different IR techniques, showing renal stones in the right kidney (red arrows). (a) Image reconstructed with adaptive statistical iterative reconstruction 80%; patient's weight 70 kg and CTDIvol: 3.84 mGy. (b) iDose4 L5; patient's weight 71 kg and CTDIvol: 5.66 mGy. (c) Sonogram affirmed iterative reconstruction 4; patient's weight 81 kg and CTDIvol: 8.74 mGy. Note the comparable image quality and contrast preservation among the different images, allowing the diagnosis of urolithiasis
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 6: Iterative reconstruction (IR) levels in computed tomography (CT) scans performed for renal stones. IR techniques decrease image noise, allowing radiation dose reduction, while image quality is preserved or even improved. High levels of IR techniques are desired for CT scans performed for renal stones. (a–c) Coronal images from different patients generated with high levels of different IR techniques, showing renal stones in the right kidney (red arrows). (a) Image reconstructed with adaptive statistical iterative reconstruction 80%; patient's weight 70 kg and CTDIvol: 3.84 mGy. (b) iDose4 L5; patient's weight 71 kg and CTDIvol: 5.66 mGy. (c) Sonogram affirmed iterative reconstruction 4; patient's weight 81 kg and CTDIvol: 8.74 mGy. Note the comparable image quality and contrast preservation among the different images, allowing the diagnosis of urolithiasis
Mentions: Introduction of iterative reconstructions such as adaptive statistical iterative reconstruction and sonogram affirmed iterative reconstruction allows substantial reduction in radiation exposure while preserving image quality. Several studies have shown the benefit of statistical-based IR reconstructions in CT for urolithiasis, allowing a considerable reduction in radiation dose [Figures 5 and 6].[497778798081]

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