Dual energy CT kidney stone differentiation in photon counting computed tomography

R. Gutjahr, C. Polster, A. Henning, S. Kappler, S. Leng, C. H. McCollough, M. U. Sedlmair, B. Schmidt, B. Krauss, T. G. Flohr

Research output: Chapter in Book/Report/Conference proceedingConference contribution

6 Scopus citations


This study evaluates the capabilities of a whole-body photon counting CT system to differentiate between four common kidney stone materials, namely uric acid (UA), calcium oxalate monohydrate (COM), cystine (CYS), and apatite (APA) ex vivo. Two different x-ray spectra (120 kV and 140 kV) were applied and two acquisition modes were investigated. The macro-mode generates two energy threshold based image-volumes and two energy bin based image-volumes. In the chesspattern-mode four energy thresholds are applied. A virtual low energy image, as well as a virtual high energy image are derived from initial threshold-based images, while considering their statistically correlated nature. The energy bin based images of the macro-mode, as well as the virtual low and high energy image of the chesspattern-mode serve as input for our dual energy evaluation. The dual energy ratio of the individually segmented kidney stones were utilized to quantify the discriminability of the different materials. The dual energy ratios of the two acquisition modes showed high correlation for both applied spectra. Wilcoxon-rank sum tests and the evaluation of the area under the receiver operating characteristics curves suggest that the UA kidney stones are best differentiable from all other materials (AUC = 1.0), followed by CYS (AUC0.9 compared against COM and APA). COM and APA, however, are hardly distinguishable (AUC between 0.63 and 0.76). The results hold true for the measurements of both spectra and both acquisition modes.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2017
Subtitle of host publicationPhysics of Medical Imaging
EditorsTaly Gilat Schmidt, Joseph Y. Lo, Thomas G. Flohr
ISBN (Electronic)9781510607095
StatePublished - 2017
EventMedical Imaging 2017: Physics of Medical Imaging - Orlando, United States
Duration: Feb 13 2017Feb 16 2017

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


OtherMedical Imaging 2017: Physics of Medical Imaging
Country/TerritoryUnited States


  • CT
  • Dual-Energy CT
  • Kidney Stone
  • Multi-Energy CT
  • Photon-Counting CT
  • Spectral CT

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging


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