Dual-layer spectral detector CT: non-inferiority assessment compared to dual-source dual-energy CT in discriminating uric acid from non-uric acid renal stones ex vivo

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Abstract

Purpose: To assess the non-inferiority of dual-layer spectral detector CT (SDCT) compared to dual-source dual-energy CT (dsDECT) in discriminating uric acid (UA) from non-UA stones. Methods: Fifty-seven extracted urinary calculi were placed in a cylindrical phantom in a water bath and scanned on a SDCT scanner (IQon, Philips Healthcare) and second- and third-generation dsDECT scanners (Somatom Flash and Force, Siemens Healthcare) under matched scan parameters. For SDCT data, conventional images and virtual monoenergetic reconstructions were created. A customized 3D growing region segmentation tool was used to segment each stone on a pixel-by-pixel basis for statistical analysis. Median virtual monoenergetic ratios (VMRs) of 40/200, 62/92, and 62/100 for each stone were recorded. For dsDECT data, dual-energy ratio (DER) for each stone was recorded from vendor-specific postprocessing software (Syngo Via) using the Kidney Stones Application. The clinical reference standard of X-ray diffraction analysis was used to assess non-inferiority. Area under the receiver-operating characteristic curve (AUC) was used to assess diagnostic performance of detecting UA stones. Results: Six pure UA, 47 pure calcium-based, 1 pure cystine, and 3 mixed struvite stones were scanned. All pure UA stones were correctly separated from non-UA stones using SDCT and dsDECT (AUC = 1). For UA stones, median VMR was 0.95–0.99 and DER 1.00–1.02. For non-UA stones, median VMR was 1.4–4.1 and DER 1.39–1.69. Conclusion: SDCT spectral reconstructions demonstrate similar performance to those of dsDECT in discriminating UA from non-UA stones in a phantom model.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Apr 7 2018

Fingerprint

Uric Acid
Kidney
Acids
Area Under Curve
Delivery of Health Care
Urinary Calculi
Kidney Calculi
Cystine
Baths
ROC Curve
X-Ray Diffraction
Software
Calcium
Water

Keywords

  • Dual-energy CT
  • Material separation
  • Spectral CT
  • Uric acid
  • Urolithiasis

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

@article{e2b34b6cb02d49b497e75f08487fd1c9,
title = "Dual-layer spectral detector CT: non-inferiority assessment compared to dual-source dual-energy CT in discriminating uric acid from non-uric acid renal stones ex vivo",
abstract = "Purpose: To assess the non-inferiority of dual-layer spectral detector CT (SDCT) compared to dual-source dual-energy CT (dsDECT) in discriminating uric acid (UA) from non-UA stones. Methods: Fifty-seven extracted urinary calculi were placed in a cylindrical phantom in a water bath and scanned on a SDCT scanner (IQon, Philips Healthcare) and second- and third-generation dsDECT scanners (Somatom Flash and Force, Siemens Healthcare) under matched scan parameters. For SDCT data, conventional images and virtual monoenergetic reconstructions were created. A customized 3D growing region segmentation tool was used to segment each stone on a pixel-by-pixel basis for statistical analysis. Median virtual monoenergetic ratios (VMRs) of 40/200, 62/92, and 62/100 for each stone were recorded. For dsDECT data, dual-energy ratio (DER) for each stone was recorded from vendor-specific postprocessing software (Syngo Via) using the Kidney Stones Application. The clinical reference standard of X-ray diffraction analysis was used to assess non-inferiority. Area under the receiver-operating characteristic curve (AUC) was used to assess diagnostic performance of detecting UA stones. Results: Six pure UA, 47 pure calcium-based, 1 pure cystine, and 3 mixed struvite stones were scanned. All pure UA stones were correctly separated from non-UA stones using SDCT and dsDECT (AUC = 1). For UA stones, median VMR was 0.95–0.99 and DER 1.00–1.02. For non-UA stones, median VMR was 1.4–4.1 and DER 1.39–1.69. Conclusion: SDCT spectral reconstructions demonstrate similar performance to those of dsDECT in discriminating UA from non-UA stones in a phantom model.",
keywords = "Dual-energy CT, Material separation, Spectral CT, Uric acid, Urolithiasis",
author = "Lakshmi Ananthakrishnan and Xinhui Duan and Yin Xi and Lewis, {Matthew A} and Pearle, {Margaret S} and Jodi Antonelli and Harold Goerne and Kolitz, {Elysha M.} and Suhny Abbara and Lenkinski, {Robert E} and Julia Fielding and John Leyendecker",
year = "2018",
month = "4",
day = "7",
doi = "10.1007/s00261-018-1589-x",
language = "English (US)",
pages = "1--7",
journal = "Abdominal Radiology",
issn = "2366-004X",
publisher = "Springer New York",

}

TY - JOUR

T1 - Dual-layer spectral detector CT

T2 - non-inferiority assessment compared to dual-source dual-energy CT in discriminating uric acid from non-uric acid renal stones ex vivo

AU - Ananthakrishnan, Lakshmi

AU - Duan, Xinhui

AU - Xi, Yin

AU - Lewis, Matthew A

AU - Pearle, Margaret S

AU - Antonelli, Jodi

AU - Goerne, Harold

AU - Kolitz, Elysha M.

AU - Abbara, Suhny

AU - Lenkinski, Robert E

AU - Fielding, Julia

AU - Leyendecker, John

PY - 2018/4/7

Y1 - 2018/4/7

N2 - Purpose: To assess the non-inferiority of dual-layer spectral detector CT (SDCT) compared to dual-source dual-energy CT (dsDECT) in discriminating uric acid (UA) from non-UA stones. Methods: Fifty-seven extracted urinary calculi were placed in a cylindrical phantom in a water bath and scanned on a SDCT scanner (IQon, Philips Healthcare) and second- and third-generation dsDECT scanners (Somatom Flash and Force, Siemens Healthcare) under matched scan parameters. For SDCT data, conventional images and virtual monoenergetic reconstructions were created. A customized 3D growing region segmentation tool was used to segment each stone on a pixel-by-pixel basis for statistical analysis. Median virtual monoenergetic ratios (VMRs) of 40/200, 62/92, and 62/100 for each stone were recorded. For dsDECT data, dual-energy ratio (DER) for each stone was recorded from vendor-specific postprocessing software (Syngo Via) using the Kidney Stones Application. The clinical reference standard of X-ray diffraction analysis was used to assess non-inferiority. Area under the receiver-operating characteristic curve (AUC) was used to assess diagnostic performance of detecting UA stones. Results: Six pure UA, 47 pure calcium-based, 1 pure cystine, and 3 mixed struvite stones were scanned. All pure UA stones were correctly separated from non-UA stones using SDCT and dsDECT (AUC = 1). For UA stones, median VMR was 0.95–0.99 and DER 1.00–1.02. For non-UA stones, median VMR was 1.4–4.1 and DER 1.39–1.69. Conclusion: SDCT spectral reconstructions demonstrate similar performance to those of dsDECT in discriminating UA from non-UA stones in a phantom model.

AB - Purpose: To assess the non-inferiority of dual-layer spectral detector CT (SDCT) compared to dual-source dual-energy CT (dsDECT) in discriminating uric acid (UA) from non-UA stones. Methods: Fifty-seven extracted urinary calculi were placed in a cylindrical phantom in a water bath and scanned on a SDCT scanner (IQon, Philips Healthcare) and second- and third-generation dsDECT scanners (Somatom Flash and Force, Siemens Healthcare) under matched scan parameters. For SDCT data, conventional images and virtual monoenergetic reconstructions were created. A customized 3D growing region segmentation tool was used to segment each stone on a pixel-by-pixel basis for statistical analysis. Median virtual monoenergetic ratios (VMRs) of 40/200, 62/92, and 62/100 for each stone were recorded. For dsDECT data, dual-energy ratio (DER) for each stone was recorded from vendor-specific postprocessing software (Syngo Via) using the Kidney Stones Application. The clinical reference standard of X-ray diffraction analysis was used to assess non-inferiority. Area under the receiver-operating characteristic curve (AUC) was used to assess diagnostic performance of detecting UA stones. Results: Six pure UA, 47 pure calcium-based, 1 pure cystine, and 3 mixed struvite stones were scanned. All pure UA stones were correctly separated from non-UA stones using SDCT and dsDECT (AUC = 1). For UA stones, median VMR was 0.95–0.99 and DER 1.00–1.02. For non-UA stones, median VMR was 1.4–4.1 and DER 1.39–1.69. Conclusion: SDCT spectral reconstructions demonstrate similar performance to those of dsDECT in discriminating UA from non-UA stones in a phantom model.

KW - Dual-energy CT

KW - Material separation

KW - Spectral CT

KW - Uric acid

KW - Urolithiasis

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U2 - 10.1007/s00261-018-1589-x

DO - 10.1007/s00261-018-1589-x

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JO - Abdominal Radiology

JF - Abdominal Radiology

SN - 2366-004X

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