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Characterization of Human Renal Stones with MDCT: Advantage of Dual Energy and Limitations Due to Respiratory Motion

Romain Grosjean1, Benoît Sauer1,2, Rui Matias Guerra1,3, Michel Daudon4, Alain Blum2, Jacques Felblinger1 and Jacques Hubert1,5

1 Interventional and Diagnostic Adaptative Imaging, INSERM ERI 13, Nancy University, Centre Hospitalier Universitaire Nancy (TD4), Rue du Morvan, 54511 Vandœuvre-les-Nancy CEDEX, France.
2 Department of Radiology, Service d'Imagerie Guilloz, Centre Hospitalier Universitaire, Nancy, France.
3 Siemens Medical Solutions, Saint Denis, France.
4 Cristal Laboratory, Necker Hospital, Paris, France.
5 Department of Urology, Centre Hospitalier Universitaire, Nancy, France.


Figure 1
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  		Fig. 1 —Photograph shows stones that were placed in jelly phantom.

 

Figure 2
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  		Fig. 2 —Diagram shows regions of interest placed within largest area of stones (120 kV; 200 mAs; soft-tissue window width, 350 H; soft-tissue window length, 40 H).

 

Figure 3
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  		Fig. 3A —Graphs show overlap of 95% CIs (200 mAs; gantry rotation time, 0.5 second; collimation, 0.75 at 80 kV [A] and 120 kV [B]). UA = uric acid, STR = struvite, CYS = cystine, COM = calcium oxalate monohydrate (whewellite), COD = calcium oxalate dihydrate (weddellite), BRU = brushite.

 

Figure 4
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  		Fig. 3B —Graphs show overlap of 95% CIs (200 mAs; gantry rotation time, 0.5 second; collimation, 0.75 at 80 kV [A] and 120 kV [B]). UA = uric acid, STR = struvite, CYS = cystine, COM = calcium oxalate monohydrate (whewellite), COD = calcium oxalate dihydrate (weddellite), BRU = brushite.

 

Figure 5
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  		Fig. 4 —Graph shows dual-kilovoltage CT attenuation values (attenuation at 80 kV minus attenuation at 120 kV) obtained with no motion. UA = uric acid, STR = struvite, CYS = cystine, COM = calcium oxalate monohydrate (whewellite), COD = calcium oxalate dihydrate (weddellite), BRU = brushite.

 

Figure 6
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  		Fig. 5A —Graphs show influence of motion on CT attenuation values (attenuation at 80 kV minus attenuation at 120 kV). UA = uric acid, STR = struvite, CYS = cystine, COM = calcium oxalate monohydrate (whewellite), COD = calcium oxalate dihydrate (weddellite), BRU = brushite. Acquisition at 80 kV.

 

Figure 7
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  		Fig. 5B —Graphs show influence of motion on CT attenuation values (attenuation at 80 kV minus attenuation at 120 kV). UA = uric acid, STR = struvite, CYS = cystine, COM = calcium oxalate monohydrate (whewellite), COD = calcium oxalate dihydrate (weddellite), BRU = brushite. Acquisition at 120 kV.

 

Figure 8
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  		Fig. 6 —Graph shows dual-kilovoltage CT attenuation (attenuation at 80 kV minus attenuation at 120 kV) obtained with simulated lack of maintenance of breath-hold. UA = uric acid, STR = struvite, CYS = cystine, COM = calcium oxalate monohydrate (whewellite), COD = calcium oxalate dihydrate (weddellite), BRU = brushite.

 

Figure 9
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  		Fig. 7 —Graph shows dual-kilovoltage CT attenuation values (attenuation at 80 kV minus attenuation at 120 kV) obtained with simulated free-breathing motion. UA = uric acid, STR = struvite, CYS = cystine, COM = calcium oxalate monohydrate (whewellite), COD = calcium oxalate dihydrate (weddellite), BRU = brushite.

 

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