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Dual-Source Dual-Energy CT in Detection and Characterization of Urinary Stones in Patients With Large Body Habitus: Observations in a Large Cohort
- Source :
- American Journal of Roentgenology. 212:796-801
- Publication Year :
- 2019
- Publisher :
- American Roentgen Ray Society, 2019.
-
Abstract
- The objective of our study was to investigate the impact of large body habitus on dual-energy CT (DECT) image quality and stone characterization.We retrospectively included 105 consecutive patients with large body habitus (90 kg) who underwent stone protocol DECT between 2015 and 2017. The evaluation of DECT datasets was performed for image quality assessment based on European Guidelines on Quality Criteria for Computed Tomography and for determination of stone composition (i.e., uric acid vs non-uric acid). Correlation between DECT characterization and crystallography results was performed when available. The cohort was divided into two groups on the basis of body weight (≤ 104 kg and104 kg), and comparisons were made for image quality and stone characterization.One hundred ninety-seven urinary tract calculi (size: mean ± SD, 5.7 ± 5.3 mm; range, 1.4-56 mm) were detected in 73% (79/108) of examinations in 105 patients (weight: mean ± SD, 104.0 ± 12.7 kg; range, 91-163 kg). The overall mean image quality score of blended images and color maps was 3.7 and 3.9, respectively, and the effective dual-energy FOV limitation did not hamper stone characterization. The diagnostic acceptability scores of blended images and color maps were slightly lower in patients weighing104 kg than in patients ≤ 104 kg (mean scores [highest score, 4 points]: blended images, 3.62 vs 3.82 [p = 0.0314]; color maps, 3.75 vs 3.98 [p = 0.0034]), but the scores were within acceptable range. Stone characterization as uric acid versus non-uric acid was achieved in 80% (158/197) of calculi (size: mean ± SD, 6.4 ± 5.7 mm; range, 1.6-56 mm), and DECT stone characterization was (95.6%) accurate with reference to crystallography. Twenty percent (39/197) of calculi could not be characterized on DECT, and these calculi were significantly smaller in size (size: mean ± SD, 2.8 ± 1.4 mm; range, 1.4-8.2 mm; p0.001) than those that could be characterized. The mean size of uncharacterized calculi was slightly larger in patients weighing104 kg (3.3 ± 1.6 mm) than in those weighing ≤ 104 kg (2.2 ± 0.6 mm).In patients with large body habitus, dual-source DECT provides acceptable image quality and allows characterization of almost all clinically significant calculi.
- Subjects :
- Adult
Male
medicine.medical_specialty
Image quality
Urinary system
030218 nuclear medicine & medical imaging
Radiography, Dual-Energy Scanned Projection
03 medical and health sciences
0302 clinical medicine
Urolithiasis
medicine
Humans
Habitus
Dual source
Radiology, Nuclear Medicine and imaging
In patient
Obesity
Aged
Retrospective Studies
Aged, 80 and over
business.industry
General Medicine
Middle Aged
Large cohort
030220 oncology & carcinogenesis
Radiographic Image Interpretation, Computer-Assisted
Female
Urinary Calculi
Radiology
Dual energy ct
Tomography, X-Ray Computed
business
Subjects
Details
- ISSN :
- 15463141 and 0361803X
- Volume :
- 212
- Database :
- OpenAIRE
- Journal :
- American Journal of Roentgenology
- Accession number :
- edsair.doi.dedup.....bb619f5b6bc718d15ff9e0b1522c2f9f