Unenhanced MDCT in suspected urolithiasis

Improved stone detection and density measurements using coronal maximum-intensity-projection images

Michael T Corwin, Margaret Hsu, John P McGahan, Machelle Wilson, Ramit Lamba

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study was to determine whether coronal maximum-intensity-projection (MIP) reformations improve urinary tract stone detection and density measurements compared with routine axial and coronal images. MATERIALS AND METHODS. Forty-five consecutive patients who underwent MDCT for suspected urolithiasis were included. Two radiologists independently determined the number of stones on 5-, 3-, and 1.25-mm axial, 5- and 3-mm coronal, and 5-mm coronal MIP images. The reference standard was obtained by consensus review using all six datasets. Stone density was determined for all calculi 4 mm or larger on all datasets. RESULTS. There were a total of 115 stones. Reader 1 identified 111 (96.5%), 112 (97.4%), 97 (84.3%), 102 (88.7%), 99 (86.1%), and 85 (73.9%) stones and reader 2 identified 105 (91.3%), 102 (88.7%), 85 (73.9%), 89 (77.4%), 89 (77.4%), and 76 (66.1%) stones on the MIP, 1.25-mm axial, 3-mm axial, 3-mm coronal, 5-mm coronal, and 5-mm axial images, respectively. Both readers identified more stones on the MIP images than on the 3- or 5-mm axial or coronal images (p < 0.0001). The mean difference in stone attenuation compared with the thin axial images was significantly less for the MIP images (44.6 HU) compared with 3-mm axial (235 HU), 3-mm coronal (309 HU), and 5-mm coronal (329.6 HU) or axial images (347.8 HU) (p < 0.0001). CONCLUSION. Coronal MIP reformations allow more accurate identification and density measurements of urinary tract stones compared with routine axial and coronal reformations.

Original languageEnglish (US)
Pages (from-to)1036-1040
Number of pages5
JournalAmerican Journal of Roentgenology
Volume201
Issue number5
DOIs
StatePublished - Nov 2013

Fingerprint

Urinary Calculi
Urolithiasis
Calculi
Datasets
Radiologists

Keywords

  • Maximum intensity projection
  • MDCT
  • Nephrolithiasis
  • Renal stones
  • Urolithiasis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{8d7801f2e34749a09ff610cb4c420fff,
title = "Unenhanced MDCT in suspected urolithiasis: Improved stone detection and density measurements using coronal maximum-intensity-projection images",
abstract = "OBJECTIVE. The purpose of this study was to determine whether coronal maximum-intensity-projection (MIP) reformations improve urinary tract stone detection and density measurements compared with routine axial and coronal images. MATERIALS AND METHODS. Forty-five consecutive patients who underwent MDCT for suspected urolithiasis were included. Two radiologists independently determined the number of stones on 5-, 3-, and 1.25-mm axial, 5- and 3-mm coronal, and 5-mm coronal MIP images. The reference standard was obtained by consensus review using all six datasets. Stone density was determined for all calculi 4 mm or larger on all datasets. RESULTS. There were a total of 115 stones. Reader 1 identified 111 (96.5{\%}), 112 (97.4{\%}), 97 (84.3{\%}), 102 (88.7{\%}), 99 (86.1{\%}), and 85 (73.9{\%}) stones and reader 2 identified 105 (91.3{\%}), 102 (88.7{\%}), 85 (73.9{\%}), 89 (77.4{\%}), 89 (77.4{\%}), and 76 (66.1{\%}) stones on the MIP, 1.25-mm axial, 3-mm axial, 3-mm coronal, 5-mm coronal, and 5-mm axial images, respectively. Both readers identified more stones on the MIP images than on the 3- or 5-mm axial or coronal images (p < 0.0001). The mean difference in stone attenuation compared with the thin axial images was significantly less for the MIP images (44.6 HU) compared with 3-mm axial (235 HU), 3-mm coronal (309 HU), and 5-mm coronal (329.6 HU) or axial images (347.8 HU) (p < 0.0001). CONCLUSION. Coronal MIP reformations allow more accurate identification and density measurements of urinary tract stones compared with routine axial and coronal reformations.",
keywords = "Maximum intensity projection, MDCT, Nephrolithiasis, Renal stones, Urolithiasis",
author = "Corwin, {Michael T} and Margaret Hsu and McGahan, {John P} and Machelle Wilson and Ramit Lamba",
year = "2013",
month = "11",
doi = "10.2214/AJR.12.10389",
language = "English (US)",
volume = "201",
pages = "1036--1040",
journal = "American Journal of Roentgenology",
issn = "0361-803X",
publisher = "American Roentgen Ray Society",
number = "5",

}

TY - JOUR

T1 - Unenhanced MDCT in suspected urolithiasis

T2 - Improved stone detection and density measurements using coronal maximum-intensity-projection images

AU - Corwin, Michael T

AU - Hsu, Margaret

AU - McGahan, John P

AU - Wilson, Machelle

AU - Lamba, Ramit

PY - 2013/11

Y1 - 2013/11

N2 - OBJECTIVE. The purpose of this study was to determine whether coronal maximum-intensity-projection (MIP) reformations improve urinary tract stone detection and density measurements compared with routine axial and coronal images. MATERIALS AND METHODS. Forty-five consecutive patients who underwent MDCT for suspected urolithiasis were included. Two radiologists independently determined the number of stones on 5-, 3-, and 1.25-mm axial, 5- and 3-mm coronal, and 5-mm coronal MIP images. The reference standard was obtained by consensus review using all six datasets. Stone density was determined for all calculi 4 mm or larger on all datasets. RESULTS. There were a total of 115 stones. Reader 1 identified 111 (96.5%), 112 (97.4%), 97 (84.3%), 102 (88.7%), 99 (86.1%), and 85 (73.9%) stones and reader 2 identified 105 (91.3%), 102 (88.7%), 85 (73.9%), 89 (77.4%), 89 (77.4%), and 76 (66.1%) stones on the MIP, 1.25-mm axial, 3-mm axial, 3-mm coronal, 5-mm coronal, and 5-mm axial images, respectively. Both readers identified more stones on the MIP images than on the 3- or 5-mm axial or coronal images (p < 0.0001). The mean difference in stone attenuation compared with the thin axial images was significantly less for the MIP images (44.6 HU) compared with 3-mm axial (235 HU), 3-mm coronal (309 HU), and 5-mm coronal (329.6 HU) or axial images (347.8 HU) (p < 0.0001). CONCLUSION. Coronal MIP reformations allow more accurate identification and density measurements of urinary tract stones compared with routine axial and coronal reformations.

AB - OBJECTIVE. The purpose of this study was to determine whether coronal maximum-intensity-projection (MIP) reformations improve urinary tract stone detection and density measurements compared with routine axial and coronal images. MATERIALS AND METHODS. Forty-five consecutive patients who underwent MDCT for suspected urolithiasis were included. Two radiologists independently determined the number of stones on 5-, 3-, and 1.25-mm axial, 5- and 3-mm coronal, and 5-mm coronal MIP images. The reference standard was obtained by consensus review using all six datasets. Stone density was determined for all calculi 4 mm or larger on all datasets. RESULTS. There were a total of 115 stones. Reader 1 identified 111 (96.5%), 112 (97.4%), 97 (84.3%), 102 (88.7%), 99 (86.1%), and 85 (73.9%) stones and reader 2 identified 105 (91.3%), 102 (88.7%), 85 (73.9%), 89 (77.4%), 89 (77.4%), and 76 (66.1%) stones on the MIP, 1.25-mm axial, 3-mm axial, 3-mm coronal, 5-mm coronal, and 5-mm axial images, respectively. Both readers identified more stones on the MIP images than on the 3- or 5-mm axial or coronal images (p < 0.0001). The mean difference in stone attenuation compared with the thin axial images was significantly less for the MIP images (44.6 HU) compared with 3-mm axial (235 HU), 3-mm coronal (309 HU), and 5-mm coronal (329.6 HU) or axial images (347.8 HU) (p < 0.0001). CONCLUSION. Coronal MIP reformations allow more accurate identification and density measurements of urinary tract stones compared with routine axial and coronal reformations.

KW - Maximum intensity projection

KW - MDCT

KW - Nephrolithiasis

KW - Renal stones

KW - Urolithiasis

UR - http://www.scopus.com/inward/record.url?scp=84886477686&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84886477686&partnerID=8YFLogxK

U2 - 10.2214/AJR.12.10389

DO - 10.2214/AJR.12.10389

M3 - Article

VL - 201

SP - 1036

EP - 1040

JO - American Journal of Roentgenology

JF - American Journal of Roentgenology

SN - 0361-803X

IS - 5

ER -