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Hounsfield units on computed tomography predict calcium stone subtype composition.

Sutchin R Patel¹, George Haleblian, August Zabbo

¹Department of Surgery, Division of Urology, Section of Minimally Invasive Urologic Surgery, and The Stone Therapy Center of New England, The Warren Alpert Medical School of Brown University, Providence, R.I., USA.

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|September 16, 2009

Summary

Hounsfield unit (HU) determination using noncontrast computed tomography (NCCT) can differentiate calcium oxalate monohydrate (CaOMH) and calcium oxalate dihydrate (CaODH) urinary stones. This imaging technique aids in predicting stone composition for patient treatment planning.

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Area of Science:

Radiology
Urology
Medical Imaging

Background:

Noncontrast computed tomography (NCCT) Hounsfield unit (HU) values can predict urinary stone composition.
Previous studies have not radiographically differentiated in vivo calcium stone subtypes.
This study investigates the efficacy of NCCT HU measurements for differentiating calcium stone subtypes.

Purpose of the Study:

To determine if Hounsfield unit (HU) measurements on noncontrast computed tomography (NCCT) can differentiate various calcium-based urinary stone subtypes.
To assess the diagnostic accuracy of NCCT in distinguishing between calcium oxalate monohydrate (CaOMH) and calcium oxalate dihydrate (CaODH) stones.

Main Methods:

Retrospective analysis of 100 patients with ureteroscopy, NCCT, and chemical stone analysis.
Inclusion criteria: stone size between 5 mm and 2 cm.
Hounsfield unit (HU) values were recorded for each stone type.

Main Results:

Mean HU values differed significantly between calcium stone subtypes.
Calcium oxalate monohydrate (CaOMH) groups showed significantly higher HU than calcium oxalate dihydrate (CaODH) (p < 0.05).
Brushite stones exhibited the highest mean HU (1,123 +/- 254), while uric acid stones had the lowest (338 +/- 145).

Conclusions:

Hounsfield unit (HU) measurement on NCCT can differentiate between calcium oxalate monohydrate (CaOMH) and calcium oxalate dihydrate (CaODH) urinary stones.
This radiographic differentiation may assist in patient counseling regarding treatment options.
NCCT HU values offer a noninvasive method to infer specific calcium stone compositions.