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. 2015:2015:801021.
doi: 10.1155/2015/801021. Epub 2015 Nov 25.

The Clinical Impact of Accurate Cystine Calculi Characterization Using Dual-Energy Computed Tomography

William E Haley  1 , El-Sayed H Ibrahim  2 , Mingliang Qu  3 , Joseph G Cernigliaro  1 , David S Goldfarb  4 , Cynthia H McCollough  3
Affiliations

The Clinical Impact of Accurate Cystine Calculi Characterization Using Dual-Energy Computed Tomography

William E Haley et al. Case Rep Radiol. 2015.

Abstract

Dual-energy computed tomography (DECT) has recently been suggested as the imaging modality of choice for kidney stones due to its ability to provide information on stone composition. Standard postprocessing of the dual-energy images accurately identifies uric acid stones, but not other types. Cystine stones can be identified from DECT images when analyzed with advanced postprocessing. This case report describes clinical implications of accurate diagnosis of cystine stones using DECT.

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Figures

Figure 1
Figure 1
Conventional CT (a) and DECT (b) images showing a large staghorn stone and a small stone in the left and right kidneys, respectively. The standard DECT postprocessing algorithm colors all non-uric-acid stones blue. A follow-up scan confirmed the location of the passed stone.
Figure 2
Figure 2
DECT scan with advanced postprocessing, which identified the stone material as cystine, in (a) left-side staghorn stone appears in this slice, and in (b), (c) two small right-side stones appear in these slices labeled small stone #1 and small stone #2, assigned a unique color (yellow). Histograms of the dual-energy ratio (DER) distribution showing mean ± SD = 1.25 ± 0.22 of staghorn stone (d), small stone #1 in (e) = 1.24 ± 0.36, and small stone #2 in (f) = 1.22 ± 0.34, which are in the range associated with cystine.
See this image and copyright information in PMC

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