Abstract
Stone analysis is a critical part of the clinical characterization of urolithiasis. This article reviews the strengths and limitations of micro CT in the analysis of stones. Using micro CT alone in a series of 757 stone specimens, micro CT identified the 458 majority calcium oxalate specimens with a sensitivity of 99.6% and specificity of 95.3%. Micro CT alone was also successful in identifying majority apatite, brushite, uric acid, and struvite stones. For some minor minerals-such as apatite in calcium oxalate or calcium salts in uric acid stones-micro CT enables the detection of minute quantities well below 1%. The addition of a standard for calibrating X-ray attenuation values improves the ability of micro CT to identify common stone minerals. The three-dimensional nature of micro CT also allows for the visualization of surface features in stones, which is valuable for the study of stone formation.
Highlights
Urinary stone analysis is an essential part of the diagnosis and treatment of stone diseases [1,2,3], but the laboratory methods used for stone analysis have remained largely unchanged for seventy years, involving the manual dissection of stones followed by molecular spectroscopy for mineral identification [4,5,6]
One technology that remains relatively novel in the field of stone analysis is micro computed tomographic imaging [7,8,9]
The method was first applied to kidney stones for ISSN : 1878-1543 https://comptes- rendus.academie- sciences.fr/chimie/
Summary
Urinary stone analysis is an essential part of the diagnosis and treatment of stone diseases [1,2,3], but the laboratory methods used for stone analysis have remained largely unchanged for seventy years, involving the manual dissection of stones followed by molecular spectroscopy for mineral identification [4,5,6]. One technology that remains relatively novel in the field of stone analysis is micro computed tomographic imaging (micro CT) [7,8,9]. It has been applied to the analysis of urinary stones for over a decade [7,11], for different kinds of kidney stones including those of calcium oxalate [12,13,14], apatite [15], brushite [16], cystine [17], and uric acid [18]. The purpose of the present paper is to introduce the technology to those unfamiliar with it, to present data on the accuracy of stone analyses done using micro CT alone, to propose a simple method for standardizing X-ray attenuation values to aid in identification of mineral type by micro CT, to describe the characteristics of different minerals as they appear by micro CT, and to show the potential of micro CT to accurately report the three-dimensional structure of stones
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