Role of Dual Energy Computed Tomography (DECT) in evaluation of renal stones

Abstract

Background: DECT is an evolving technique used for in vivo analysis of urinary calculi chemical composition. This study aims to assess the role of Dual Energy computed Tomography (DECT) in evaluation of renal stones composition. This study is a prospective cohort study, it included 30 patients. Classic single energy examinations were done (100-120 kVp) followed by DECT performed by using a single-source dual energy with fast switching between two kilovoltages (80, 135 kVp). Results of DECT were then compared to crystallography. Results: (20 males and 10 females) with known renal stones were examined; no age or sex predilection, patients aged from (16) to (79) years. From all the examined 37 stones, DECT predicted chemical composition of stones as 24 Ca oxalate stones, 8 uric acid stones and 5 cystine stones. DECT accurately identified all uric acid stones. DECT recognized 2 stones as Ca oxalate and they were proven to be Ca phosphate by crystallography. DECT also failed to identify mixed compositions in 2 stones which were diagnosed as Ca oxalate and cystine stones. Statistical analysis revealed a reliable agreement between DECT and crystallography with a (p-value) of >0.001 (highly significant). Conclusion: DECT was found as an effective method for in vivo analysis of renal stones to choose the appropriate treatment plan.