A novel method for prediction of stone composition: the average and difference of Hounsfield units and their cut-off values

Purpose

The purpose of the study was to investigate the predictive value of stone measurements by including a novel method on non-contrast computed tomography (NCCT) images for stone composition.

Methods

We retrospectively evaluated patients who had stone analysis, NCCT images, and underwent percutaneous nephrolithotomy between 2013 and 2016. Patient characteristics, stone measurements on NCCT images, and stone analysis results were evaluated. Hounsfield unit (HU) values (maximum (HU_max), minimum (HU_min), and average (HU_ave) of HU values) were investigated on NCCT images. HU_diff was calculated as the difference between the HU_max and the HU_min values. Patients were divided into seven stone groups and data were compared. Then patients were separately divided into two groups according to mineral complexity (mono-mineral and multi-mineral groups) and calcium-based (calcium and other stone groups) evaluation.

Results

In the study, 115 patients were evaluated. Age, gender, HU_min, HU_max, and HU_ave were significantly different between the stone groups. HU_diff and HU_ave were found to be 341.5 HU (AUC?=?0.719, p?=?0.017) and 1051.5 HU (AUC?=?0.701, p?=?0.029) as cut-off, respectively. Seventy of 72?>?341.5 HU_diff patients and 64 of 67?>?1051.5 HU_ave patients had multi-mineral stones (p?=?0.001, OR 9.26, and p?=?0.028, OR 4.27), respectively. In multivariate analysis, >?341.5 HU_diff rate was significantly higher in multi-mineral and calcium stone groups; HU_ave was also significantly higher in the calcium stone group.

Conclusions

HU_diff and HU_ave were significant predictors of mineral complexity. HU_diff of