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Title: Using Helical CT to Predict Stone Fragility in Shock Wave Lithotripsy (SWL)

Abstract

Great variability exists in the response of urinary stones to SWL, and this is true even for stones composed of the same mineral. Efforts have been made to predict stone fragility to shock waves using computed tomography (CT) patient images, but most work to date has focused on the use of stone CT number (i.e., Hounsfield units). This is an easy number to measure on a patient stone, but its value depends on a number of factors, including the relationship of the size of the stone to me resolution (i.e., the slicewidth) of the CT scan. Studies that have shown a relationship between stone CT number and failure in SWL are reviewed, and all are shown to suffer from error due to stone size, which was not accounted for in the use of Hounsfield unit values. Preliminary data are then presented for a study of calcium oxalate monohydrate (COM) stones, in which stone structure-rather than simple CT number values-is shown to correlate with fragility to shock waves. COM stones that were observed to have structure by micro CT (e.g., voids, apatite regions, unusual shapes) broke to completion in about half the number of shock waves required for COM stones thatmore » were observed to be homogeneous in structure by CT. This result suggests another direction for the use of CT in predicting success of SWL: the use of CT to view stone structure, rather than simply measuring stone CT number. Viewing stone structure by CT requires the use of different viewing windows than those typically used for examining patient scans, but much research to date indicates that stone structure can be observed in the clinical setting. Future clinical studies will need to be done to verify the relationship between stone structure observed by CT and stone fragility in SWL.« less

Authors:
; ; ;  [1];  [2]
  1. Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN 46202 (United States)
  2. Methodist Hospital Institute for Kidney Stone Disease, 1801 North Senate Boulevard, Suite 220, Indianapolis, Indiana 46202 (United States)
Publication Date:
OSTI Identifier:
21056958
Resource Type:
Journal Article
Resource Relation:
Journal Name: AIP Conference Proceedings; Journal Volume: 900; Journal Issue: 1; Conference: 1. Annual international urolithiasis research symposium, Indianapolis, IN (United States), 2-3 Nov 2006; Other Information: DOI: 10.1063/1.2723592; (c) 2007 American Institute of Physics; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; APATITES; BIOLOGICAL EFFECTS; CALCIUM COMPOUNDS; CAT SCANNING; DISEASES; HYDRATES; IMAGES; KIDNEYS; OXALATES; RESOLUTION; SHOCK WAVES

Citation Formats

Williams, James C. Jr., Zarse, Chad A., Jackson, Molly E., McAteer, James A., and Lingeman, James E. Using Helical CT to Predict Stone Fragility in Shock Wave Lithotripsy (SWL). United States: N. p., 2007. Web. doi:10.1063/1.2723592.
Williams, James C. Jr., Zarse, Chad A., Jackson, Molly E., McAteer, James A., & Lingeman, James E. Using Helical CT to Predict Stone Fragility in Shock Wave Lithotripsy (SWL). United States. doi:10.1063/1.2723592.
Williams, James C. Jr., Zarse, Chad A., Jackson, Molly E., McAteer, James A., and Lingeman, James E. Thu . "Using Helical CT to Predict Stone Fragility in Shock Wave Lithotripsy (SWL)". United States. doi:10.1063/1.2723592.
@article{osti_21056958,
title = {Using Helical CT to Predict Stone Fragility in Shock Wave Lithotripsy (SWL)},
author = {Williams, James C. Jr. and Zarse, Chad A. and Jackson, Molly E. and McAteer, James A. and Lingeman, James E.},
abstractNote = {Great variability exists in the response of urinary stones to SWL, and this is true even for stones composed of the same mineral. Efforts have been made to predict stone fragility to shock waves using computed tomography (CT) patient images, but most work to date has focused on the use of stone CT number (i.e., Hounsfield units). This is an easy number to measure on a patient stone, but its value depends on a number of factors, including the relationship of the size of the stone to me resolution (i.e., the slicewidth) of the CT scan. Studies that have shown a relationship between stone CT number and failure in SWL are reviewed, and all are shown to suffer from error due to stone size, which was not accounted for in the use of Hounsfield unit values. Preliminary data are then presented for a study of calcium oxalate monohydrate (COM) stones, in which stone structure-rather than simple CT number values-is shown to correlate with fragility to shock waves. COM stones that were observed to have structure by micro CT (e.g., voids, apatite regions, unusual shapes) broke to completion in about half the number of shock waves required for COM stones that were observed to be homogeneous in structure by CT. This result suggests another direction for the use of CT in predicting success of SWL: the use of CT to view stone structure, rather than simply measuring stone CT number. Viewing stone structure by CT requires the use of different viewing windows than those typically used for examining patient scans, but much research to date indicates that stone structure can be observed in the clinical setting. Future clinical studies will need to be done to verify the relationship between stone structure observed by CT and stone fragility in SWL.},
doi = {10.1063/1.2723592},
journal = {AIP Conference Proceedings},
number = 1,
volume = 900,
place = {United States},
year = {Thu Apr 05 00:00:00 EDT 2007},
month = {Thu Apr 05 00:00:00 EDT 2007}
}