Dual-energy dual-source CT with additional spectral filtration can improve the differentiation of non-uric acid renal stones: an ex vivo phantom study.
Dual-energy dual-source CT with additional spectral filtration can improve the differentiation of non-uric acid renal stones: an ex vivo phantom study.
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DOI：
10.2214/ajr.10.5041
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发表时间：
2011-06
期刊：
影响因子：
--
通讯作者：
McCollough CH
中科院分区：
文献类型：
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作者：
Qu M;Ramirez-Giraldo JC;Leng S;Williams JC;Vrtiska TJ;Lieske JC;McCollough CH
确定双能量、双源计算机断层扫描（DE-DSCT）结合额外锡过滤区分5组人类肾结石类型的离体能力。根据有效原子序数将10种类型的43种肾结石分为5个主要组，有效原子序数是组成原子序数的加权平均值。将结石嵌入猪肾中，并置于35 cm水模体中。在80/140 kV下进行有和无锡过滤的DE-DSCT扫描。CT数比[CTR=CT（低）/CT（高）]是根据每个结石的体积逐体素计算的。进行统计学分析，绘制受试者工作特征（ROC）曲线，比较有无锡过滤CTR的差异，并测量结石组之间的区分。非尿酸结石的CTR平均增加0.17（范围0.03-0.36）。非尿酸结石组的CTR值在没有锡过滤的任何两个相邻组之间没有显著差异（p>0.05）。在高能X射线管上使用额外的锡过滤显著改善了CTR对非尿酸结石类型的分离（p<0.05）。ROC曲线下面积从无翅片过滤的0.78-0.84增加到有锡过滤的0.89-0.95。我们的结果表明，当在DE-DSCT上使用额外的锡过滤时，不同结石类型之间的分离更好。增加的光谱分离允许5组结石分类方案。某些特定结石类型之间的重叠仍然存在，包括透钙磷石和草酸钙。
To determine the ex vivo ability of dual-energy, dual-source computed tomography (DE-DSCT) with additional tin filtration to differentiate between five groups of human renal stone types. Forty-three renal stones of ten types were categorized into five primary groups based on effective atomic numbers, which were calculated as the weighted average of the atomic numbers of constituent atoms. Stones were embedded in porcine kidneys and placed in a 35cm water phantom. DE-DSCT scans were performed with and without tin filtration at 80/140kV. The CT number ratio [CTR=CT(low)/CT(high)] was calculated on a volumetric voxel-by-voxel basis for each stone. Statistical analysis was performed and receiver operating characteristic (ROC) curves were plotted to compare the difference in CTR with and without tin filtration, and to measure the discrimination between stone groups. CTR of non-uric acid stones increased on average by 0.17 (range 0.03–0.36) with tin filtration. The CTR values for non-uric acid stone groups were not significantly different (p>0.05) between any of the two adjacent groups without tin filtration. Use of the additional tin filtration on the high-energy x-ray tube significantly improved the separation of non-uric acid stone types by CTR (p<0.05). The area under the ROC curve increased from 0.78–0.84 without fin filtration to 0.89–0.95 with tin filtration. Our results demonstrated better separation between different stone types when additional tin filtration was used on DE-DSCT. The increased spectral separation allowed a 5-group stone classification scheme. Some overlapping between particular stone types still exists, including brushite and calcium oxalate.