Detection of Uric Acid Stones in the Ureter Using Low- And Conventional-Dose Computed Tomography

Urology. 2014 Sep;84(3):571-4. doi: 10.1016/j.urology.2014.02.021. Epub 2014 Apr 17.

Abstract

Objective: To determine the ability of low- and conventional-dose computed tomography (CT) in identification of uric acid stones, which are of lower density than calcium oxalate stones.

Materials and methods: Uric acid stones (3, 5, and 7 mm) were randomly placed in human cadaveric ureters and scanned using conventional 140-mAs and low-dose 70-, 50-, 30-, 15-, 7.5-, and 5-mAs settings. A single-blinded radiologist reviewed a total of 523 scanned stone images. Sensitivity and specificity were compared among different settings and stone sizes.

Results: Imaging using 140-, 70-, 50-, 30-, 15-, 7.5-, and 5-mAs settings resulted in 97%, 97%, 96%, 93%, 83%, 83%, and 69% sensitivity and 92%, 92%, 91%, 89%, 88%, 91%, and 94% specificity, respectively. There was a significant difference in sensitivity between 140 mAs and 15, 7.5, and 5 mAs (P = .011, P = .011, and P <.001, respectively). Sensitivity for 3-, 5-, and 7-mm stones was 83%, 90%, and 93%, respectively. At ≤ 15 mAs, 3-mm stones had a higher rate of false negatives (P <.001).

Conclusion: Both low- and conventional-dose CTs demonstrate excellent sensitivity and specificity for the detection of ureteral uric acid stones. However, low-dose CT at ≤ 15 mAs resulted in reduced detection of uric acid stones.

MeSH terms

  • Cadaver
  • Calcium Oxalate / chemistry
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Observer Variation
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed*
  • Ureter / diagnostic imaging
  • Ureteral Calculi / diagnosis*
  • Ureteral Calculi / diagnostic imaging*
  • Uric Acid / analysis*

Substances

  • Calcium Oxalate
  • Uric Acid