title: Non-invasive differentiation of kidney stone types using X-ray dark-field radiography.
abstract: Treatment of renal calculi is highly dependent on the chemical composition of the stone in question, which is difficult to determine using standard imaging techniques. The objective of this study is to evaluate the potential of scatter-sensitive X-ray dark-field radiography to differentiate between the most common types of kidney stones in clinical practice. Here, we examine the absorption-to-scattering ratio of 118 extracted kidney stones with a laboratory Talbot-Lau Interferometer. Depending on their chemical composition, microscopic growth structure and morphology the various types of kidney stones show strongly varying, partially opposite contrasts in absorption and dark-field imaging. By assessing the microscopic calculi morphology with high resolution micro-computed tomography measurements, we illustrate the dependence of dark-field signal strength on the respective stone type. Finally, we utilize X-ray dark-field radiography as a non-invasive, highly sensitive (100%) and specific (97%) tool for the differentiation of calcium oxalate, uric acid and mixed types of stones, while additionally improving the detectability of radio-lucent calculi. We prove clinical feasibility of the here proposed method by accurately classifying renal stones, embedded within a fresh pig kidney, using dose-compatible measurements and a quick and simple visual inspection.
authors: Lehrstuhl für Biomedizinische Physik, Physik-Department &Institut für Medizintechnik, Technische Universität München, Garching, Germany.
authors: Kai
authors: K
authors: Scherer
authors: Lehrstuhl für Biomedizinische Physik, Physik-Department &Institut für Medizintechnik, Technische Universität München, Garching, Germany.
authors: Eva
authors: E
authors: Braig
authors: Lehrstuhl für Biomedizinische Physik, Physik-Department &Institut für Medizintechnik, Technische Universität München, Garching, Germany.
authors: Konstantin
authors: K
authors: Willer
authors: Lehrstuhl für Biomedizinische Physik, Physik-Department &Institut für Medizintechnik, Technische Universität München, Garching, Germany.
authors: Marian
authors: M
authors: Willner
authors: Department of Radiology, Technische Universität München, Munich, Germany.
authors: Alexander A
authors: AA
authors: Fingerle
authors: Lehrstuhl für Biomedizinische Physik, Physik-Department &Institut für Medizintechnik, Technische Universität München, Garching, Germany.
authors: Michael
authors: M
authors: Chabior
authors: Lehrstuhl für Biomedizinische Physik, Physik-Department &Institut für Medizintechnik, Technische Universität München, Garching, Germany.
authors: Julia
authors: J
authors: Herzen
authors: Department of Radiology, Technische Universität München, Munich, Germany.
authors: Matthias
authors: M
authors: Eiber
authors: Department of Medical Statistics and Epidemiology, Technische Universität München, Munich, Germany.
authors: Bernhard
authors: B
authors: Haller
authors: Department of Urology, Technische Universität München, Munich, Germany.
authors: Michael
authors: M
authors: Straub
authors: Department of Clinical Chemistry and Pathobiochemistry, Technische Universität München, Munich, Germany.
authors: Heike
authors: H
authors: Schneider
authors: Department of Radiology, Technische Universität München, Munich, Germany.
authors: Ernst J
authors: EJ
authors: Rummeny
authors: Department of Radiology, Technische Universität München, Munich, Germany.
authors: Peter B
authors: PB
authors: Noël
authors: Lehrstuhl für Biomedizinische Physik, Physik-Department &Institut für Medizintechnik, Technische Universität München, Garching, Germany.
authors: Franz
authors: F
authors: Pfeiffer
mesh_terms: D000327:Adsorption; D002129:Calcium Oxalate / Q000737:chemistry; D006801:Humans; D007669:Kidney Calculi / Q000737:chemistry* / Q000000981:diagnostic imaging*; D012372:ROC Curve; D015203:Reproducibility of Results; D014527:Uric Acid / Q000737:chemistry; D055114:X-Ray Microtomography / Q000379:methods
chemical_list: D002129:Calcium Oxalate; D014527:Uric Acid