Computed Tomography Evaluation of Urinary Stones Densities Compared to in Vitro Analysis of Its Chemical Composition

Hamdy Ibrahim; Nagwa Wilson; Mahmoud Abdel Wahab; Haney Heneidy

doi:doi:10.11648/j.ijmi.20140206.14

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Computed Tomography Evaluation of Urinary Stones Densities Compared to in Vitro Analysis of Its Chemical Composition

Hamdy Ibrahim, Nagwa Wilson, Mahmoud Abdel Wahab, Haney Heneidy

Published in International Journal of Medical Imaging (Volume 2, Issue 6)

Received: 28 November 2014 Accepted: 16 December 2014 Published: 22 December 2014

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Abstract

Purpose: The aim of the study was to compare between the urinary stones of different chemical composition and their radio-densities (Computed Tomography attenuation values or Housefield Units). The prediction of the stone type would in turn lead to better selection of the interventional modalities. Materials & Methods: A retrospective review was performed for patients who underwent pretreatment Non Contrast Computed Tomography scan for urinary stones. When measuring stone density in Hounsfield unit (HU) on Computed Tomography, a Standard Deviation (SD) was calculated for the measured area of interest that contained several pixels and a standardized area of interest of 0.026 cm2, equivalent to 25 pixels, was used. Determination of chemical constituents of stones/fragments was done using Fourier Transform Infrared Spectroscopy (FT-IR spectroscopy). Our laboratory report indicated stones of mixed composition by listing the components in rank order with quantification of their presence and we compared the Hounsfield density of the stones with the chemical findings. Results: The chemical composition of uric acid, mixed oxalate and calcium oxalate monohydrate stones was accurately identified based on the absolute Computed Tomography value. The mean Housefield Unit (HU) density for uric acid stone was 459±80, which was considerably lower than those of other stones. Mixed oxalate calculi could be distinguished from uric acid, calcium oxalate monohydrate and apatite stones by the absolute Computed Tomography value (the mean Housefield Unit density was 777±224). Moreover, calcium oxalate monohydrate stones were easily distinguished from all stones using the absolute Computed Tomography value (the mean Housefield Unit density was 1158±156) except when compared to apatite containing stones, which were not commonly encountered. The difference of Computed Tomography value, among the above-mentioned stones, was statistically significant (p<0.001). Conclusion: This study demonstrated that Computed Tomography scanning could predict the chemical composition of urinary stones. The Hounsfield density was a convenient radiographic measure that correlated well with the chemical composition. A significant correlation between the stone size and Housefield Unit values was also demonstrated.

Published in	International Journal of Medical Imaging (Volume 2, Issue 6)
DOI	10.11648/j.ijmi.20140206.14
Page(s)	141-145
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Stones, Density, Infrared Spectroscopy, Chemistry

References

[1]	Mostafavi MR, Ernst RD, Saltzman B. Accurate determination of chemical composition of urinary calculi by spiral computerized tomography.J Urol. 1998; 159:673-675.
[2]	Saw KC, McAteer JA, Monga AG, Chua GT, Lingeman JE, Williams JC,Jr. Helical CT of Urinary Calculi: Effect of Stone Composition, Stone Size, and Scan Collimation. Am J Roentgenol. 2000; 175:329.
[3]	Williams J,James C., Saw KC, Paterson RF, Hatt EK, McAteer JA, Lingeman JE. Variability of renal stone fragility in shock wave lithotripsy. Urology. 2003; 61:1092-1096.
[4]	Williams JC Jr, Kim SC, Zarse CA, McAteer JA and Lingeman JE: Progress in the use of helical CT for imaging urinary calculi. J Endourol, 2004; 18 (10): 937-941.
[5]	Williams J,J C., Saw KC, Monga AG, Chua GT, Lingeman JE, McAteer JA. Correction of helical CT attenuation values with wide beam collimation: in vitro test with urinary calculi. AcadRadiol. 2001; 8:478-483.
[6]	Hidas G, Eliahou R, Duvdevani M, et al. Determination of renal stone composition with dual-energy CT: in vivo analysis and comparison with x-ray diffraction. Radiology. 2010;257:394-401.
[7]	Manglaviti G, Tresoldi S, Guerrer CS, et al. In vivo evaluation of the chemical composition of urinary stones using dual-energy CT. AJR.American journal of roentgenology. 2011;197:W76-W83.
[8]	Graser A, Johnson TRC, Bader M, et al. Dual energy CT characterization of urinary calculi: initial in vitro and clinical experience. Invest Radiol. 2008; 43:112-119.
[9]	Kambadakone AR, Eisner BH, Catalano OA, Sahani DV. New and evolving concepts in the imaging and management of urolithiasis: urologists' perspective. Radiographics : a review publication of the Radiological Society of North America, Inc. 2010;30:603.
[10]	Bellin M, Renard-Penna R, Conort P, et al. Helical CT evaluation of the chemical composition of urinary tract calculi with a discriminant analysis of CT-attenuation values and density. EurRadiol. 2004;14:2134-2140.
[11]	Sheir KZ, Mansour O, Madbouly K, Elsobky E, Abdel-Khalek M. Determination of the chemical composition of urinary calculi by noncontrast spiral computerized tomography. Urol Res. 2005; 33:99-104.
[12]	Mostafavi MR, Ernst RD, Saltzman B. Accurate determination of chemical composition of urinary calculi by spiral computerized tomography. J Urol. 1998; 159:673-675.
[13]	Boll DT, Patil NA, Paulson EK, et al. Renal stone assessment with dual-energy multidetector CT and advanced postprocessing techniques: improved characterization of renal stone composition--pilot study. Radiology. 2009; 250:813-820.
[14]	Da Silva SFR, Silva SL, Daher EF, Silva Junior GB, Mota RMS, Bruno da Silva CA. Determination of urinary stone composition based on stone morphology: a prospective study of 325 consecutive patients in an emerging country. Clinical chemistry and laboratory medicine: CCLM / FESCC. 2009; 47:561.
[15]	Williams JC, Paterson RF, Kopecky KK, Lingeman JE, McAteer JA. High resolution detection of internal structure of renal calculi by helical computerized tomography. J Urol. 2002;167:322-326.
[16]	Akbar SA, Mortele KJ, Baeyens K, Kekelidze M, Silverman SG. Multidetector CT urography: techniques, clinical applications, and pitfalls. Seminars in Ultrasound, CT, and MRI. 2004; 25:41-54.

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APA Style

Hamdy Ibrahim, Nagwa Wilson, Mahmoud Abdel Wahab, Haney Heneidy. (2014). Computed Tomography Evaluation of Urinary Stones Densities Compared to in Vitro Analysis of Its Chemical Composition. International Journal of Medical Imaging, 2(6), 141-145. https://doi.org/10.11648/j.ijmi.20140206.14

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ACS Style

Hamdy Ibrahim; Nagwa Wilson; Mahmoud Abdel Wahab; Haney Heneidy. Computed Tomography Evaluation of Urinary Stones Densities Compared to in Vitro Analysis of Its Chemical Composition. Int. J. Med. Imaging 2014, 2(6), 141-145. doi: 10.11648/j.ijmi.20140206.14

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AMA Style

Hamdy Ibrahim, Nagwa Wilson, Mahmoud Abdel Wahab, Haney Heneidy. Computed Tomography Evaluation of Urinary Stones Densities Compared to in Vitro Analysis of Its Chemical Composition. Int J Med Imaging. 2014;2(6):141-145. doi: 10.11648/j.ijmi.20140206.14

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@article{10.11648/j.ijmi.20140206.14,
  author = {Hamdy Ibrahim and Nagwa Wilson and Mahmoud Abdel Wahab and Haney Heneidy},
  title = {Computed Tomography Evaluation of Urinary Stones Densities Compared to in Vitro Analysis of Its Chemical Composition},
  journal = {International Journal of Medical Imaging},
  volume = {2},
  number = {6},
  pages = {141-145},
  doi = {10.11648/j.ijmi.20140206.14},
  url = {https://doi.org/10.11648/j.ijmi.20140206.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20140206.14},
  abstract = {Purpose: The aim of the study was to compare between the urinary stones of different chemical composition and their radio-densities (Computed Tomography attenuation values or Housefield Units). The prediction of the stone type would in turn lead to better selection of the interventional modalities. Materials & Methods: A retrospective review was performed for patients who underwent pretreatment Non Contrast Computed Tomography scan for urinary stones. When measuring stone density in Hounsfield unit (HU) on Computed Tomography, a Standard Deviation (SD) was calculated for the measured area of interest that contained several pixels and a standardized area of interest of 0.026 cm2, equivalent to 25 pixels, was used. Determination of chemical constituents of stones/fragments was done using Fourier Transform Infrared Spectroscopy (FT-IR spectroscopy). Our laboratory report indicated stones of mixed composition by listing the components in rank order with quantification of their presence and we compared the Hounsfield density of the stones with the chemical findings. Results: The chemical composition of uric acid, mixed oxalate and calcium oxalate monohydrate stones was accurately identified based on the absolute Computed Tomography value. The mean Housefield Unit (HU) density for uric acid stone was 459±80, which was considerably lower than those of other stones. Mixed oxalate calculi could be distinguished from uric acid, calcium oxalate monohydrate and apatite stones by the absolute Computed Tomography value (the mean Housefield Unit density was 777±224). Moreover, calcium oxalate monohydrate stones were easily distinguished from all stones using the absolute Computed Tomography value (the mean Housefield Unit density was 1158±156) except when compared to apatite containing stones, which were not commonly encountered. The difference of Computed Tomography value, among the above-mentioned stones, was statistically significant (p<0.001). Conclusion: This study demonstrated that Computed Tomography scanning could predict the chemical composition of urinary stones. The Hounsfield density was a convenient radiographic measure that correlated well with the chemical composition. A significant correlation between the stone size and Housefield Unit values was also demonstrated.},
 year = {2014}
}

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TY  - JOUR
T1  - Computed Tomography Evaluation of Urinary Stones Densities Compared to in Vitro Analysis of Its Chemical Composition
AU  - Hamdy Ibrahim
AU  - Nagwa Wilson
AU  - Mahmoud Abdel Wahab
AU  - Haney Heneidy
Y1  - 2014/12/22
PY  - 2014
N1  - https://doi.org/10.11648/j.ijmi.20140206.14
DO  - 10.11648/j.ijmi.20140206.14
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 141
EP  - 145
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20140206.14
AB  - Purpose: The aim of the study was to compare between the urinary stones of different chemical composition and their radio-densities (Computed Tomography attenuation values or Housefield Units). The prediction of the stone type would in turn lead to better selection of the interventional modalities. Materials & Methods: A retrospective review was performed for patients who underwent pretreatment Non Contrast Computed Tomography scan for urinary stones. When measuring stone density in Hounsfield unit (HU) on Computed Tomography, a Standard Deviation (SD) was calculated for the measured area of interest that contained several pixels and a standardized area of interest of 0.026 cm2, equivalent to 25 pixels, was used. Determination of chemical constituents of stones/fragments was done using Fourier Transform Infrared Spectroscopy (FT-IR spectroscopy). Our laboratory report indicated stones of mixed composition by listing the components in rank order with quantification of their presence and we compared the Hounsfield density of the stones with the chemical findings. Results: The chemical composition of uric acid, mixed oxalate and calcium oxalate monohydrate stones was accurately identified based on the absolute Computed Tomography value. The mean Housefield Unit (HU) density for uric acid stone was 459±80, which was considerably lower than those of other stones. Mixed oxalate calculi could be distinguished from uric acid, calcium oxalate monohydrate and apatite stones by the absolute Computed Tomography value (the mean Housefield Unit density was 777±224). Moreover, calcium oxalate monohydrate stones were easily distinguished from all stones using the absolute Computed Tomography value (the mean Housefield Unit density was 1158±156) except when compared to apatite containing stones, which were not commonly encountered. The difference of Computed Tomography value, among the above-mentioned stones, was statistically significant (p<0.001). Conclusion: This study demonstrated that Computed Tomography scanning could predict the chemical composition of urinary stones. The Hounsfield density was a convenient radiographic measure that correlated well with the chemical composition. A significant correlation between the stone size and Housefield Unit values was also demonstrated.
VL  - 2
IS  - 6
ER  -

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Author Information

Hamdy Ibrahim

Departments of urology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
Nagwa Wilson

Department of Radiology, McGill University, Montreal, Canada
Mahmoud Abdel Wahab

Department of Biochemsitry, Faculty of Medicine, Fayoum University, Fayoum, Egypt
Haney Heneidy

Department of Radiology, Medical Research Institute, Alexandria University, Alexandria, Egypt

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APA Style

Hamdy Ibrahim, Nagwa Wilson, Mahmoud Abdel Wahab, Haney Heneidy. (2014). Computed Tomography Evaluation of Urinary Stones Densities Compared to in Vitro Analysis of Its Chemical Composition. International Journal of Medical Imaging, 2(6), 141-145. https://doi.org/10.11648/j.ijmi.20140206.14

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ACS Style

Hamdy Ibrahim; Nagwa Wilson; Mahmoud Abdel Wahab; Haney Heneidy. Computed Tomography Evaluation of Urinary Stones Densities Compared to in Vitro Analysis of Its Chemical Composition. Int. J. Med. Imaging 2014, 2(6), 141-145. doi: 10.11648/j.ijmi.20140206.14

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AMA Style

Hamdy Ibrahim, Nagwa Wilson, Mahmoud Abdel Wahab, Haney Heneidy. Computed Tomography Evaluation of Urinary Stones Densities Compared to in Vitro Analysis of Its Chemical Composition. Int J Med Imaging. 2014;2(6):141-145. doi: 10.11648/j.ijmi.20140206.14

Copy | Download

@article{10.11648/j.ijmi.20140206.14,
  author = {Hamdy Ibrahim and Nagwa Wilson and Mahmoud Abdel Wahab and Haney Heneidy},
  title = {Computed Tomography Evaluation of Urinary Stones Densities Compared to in Vitro Analysis of Its Chemical Composition},
  journal = {International Journal of Medical Imaging},
  volume = {2},
  number = {6},
  pages = {141-145},
  doi = {10.11648/j.ijmi.20140206.14},
  url = {https://doi.org/10.11648/j.ijmi.20140206.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20140206.14},
  abstract = {Purpose: The aim of the study was to compare between the urinary stones of different chemical composition and their radio-densities (Computed Tomography attenuation values or Housefield Units). The prediction of the stone type would in turn lead to better selection of the interventional modalities. Materials & Methods: A retrospective review was performed for patients who underwent pretreatment Non Contrast Computed Tomography scan for urinary stones. When measuring stone density in Hounsfield unit (HU) on Computed Tomography, a Standard Deviation (SD) was calculated for the measured area of interest that contained several pixels and a standardized area of interest of 0.026 cm2, equivalent to 25 pixels, was used. Determination of chemical constituents of stones/fragments was done using Fourier Transform Infrared Spectroscopy (FT-IR spectroscopy). Our laboratory report indicated stones of mixed composition by listing the components in rank order with quantification of their presence and we compared the Hounsfield density of the stones with the chemical findings. Results: The chemical composition of uric acid, mixed oxalate and calcium oxalate monohydrate stones was accurately identified based on the absolute Computed Tomography value. The mean Housefield Unit (HU) density for uric acid stone was 459±80, which was considerably lower than those of other stones. Mixed oxalate calculi could be distinguished from uric acid, calcium oxalate monohydrate and apatite stones by the absolute Computed Tomography value (the mean Housefield Unit density was 777±224). Moreover, calcium oxalate monohydrate stones were easily distinguished from all stones using the absolute Computed Tomography value (the mean Housefield Unit density was 1158±156) except when compared to apatite containing stones, which were not commonly encountered. The difference of Computed Tomography value, among the above-mentioned stones, was statistically significant (p<0.001). Conclusion: This study demonstrated that Computed Tomography scanning could predict the chemical composition of urinary stones. The Hounsfield density was a convenient radiographic measure that correlated well with the chemical composition. A significant correlation between the stone size and Housefield Unit values was also demonstrated.},
 year = {2014}
}

Copy | Download

TY  - JOUR
T1  - Computed Tomography Evaluation of Urinary Stones Densities Compared to in Vitro Analysis of Its Chemical Composition
AU  - Hamdy Ibrahim
AU  - Nagwa Wilson
AU  - Mahmoud Abdel Wahab
AU  - Haney Heneidy
Y1  - 2014/12/22
PY  - 2014
N1  - https://doi.org/10.11648/j.ijmi.20140206.14
DO  - 10.11648/j.ijmi.20140206.14
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 141
EP  - 145
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20140206.14
AB  - Purpose: The aim of the study was to compare between the urinary stones of different chemical composition and their radio-densities (Computed Tomography attenuation values or Housefield Units). The prediction of the stone type would in turn lead to better selection of the interventional modalities. Materials & Methods: A retrospective review was performed for patients who underwent pretreatment Non Contrast Computed Tomography scan for urinary stones. When measuring stone density in Hounsfield unit (HU) on Computed Tomography, a Standard Deviation (SD) was calculated for the measured area of interest that contained several pixels and a standardized area of interest of 0.026 cm2, equivalent to 25 pixels, was used. Determination of chemical constituents of stones/fragments was done using Fourier Transform Infrared Spectroscopy (FT-IR spectroscopy). Our laboratory report indicated stones of mixed composition by listing the components in rank order with quantification of their presence and we compared the Hounsfield density of the stones with the chemical findings. Results: The chemical composition of uric acid, mixed oxalate and calcium oxalate monohydrate stones was accurately identified based on the absolute Computed Tomography value. The mean Housefield Unit (HU) density for uric acid stone was 459±80, which was considerably lower than those of other stones. Mixed oxalate calculi could be distinguished from uric acid, calcium oxalate monohydrate and apatite stones by the absolute Computed Tomography value (the mean Housefield Unit density was 777±224). Moreover, calcium oxalate monohydrate stones were easily distinguished from all stones using the absolute Computed Tomography value (the mean Housefield Unit density was 1158±156) except when compared to apatite containing stones, which were not commonly encountered. The difference of Computed Tomography value, among the above-mentioned stones, was statistically significant (p<0.001). Conclusion: This study demonstrated that Computed Tomography scanning could predict the chemical composition of urinary stones. The Hounsfield density was a convenient radiographic measure that correlated well with the chemical composition. A significant correlation between the stone size and Housefield Unit values was also demonstrated.
VL  - 2
IS  - 6
ER  -

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