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Background and objectives <p>Radiation exposure remains a major concern for patients with urolithiasis who undergo frequent imaging for diagnosis, treatment, and follow-up. The dusting technique generates numerous small-sized fragments and dust particles, some of which remain in the kidney as residual stones. Although ultra-low-dose computed tomography (ULDCT) has demonstrated comparable performance to standard-dose computed tomography (SDCT) for detecting urinary stones above a certain size, its utility in detecting very small stones (&lt; 2–3&#xa0;mm) has not been thoroughly investigated. This study aimed to evaluate the comparability of CT-derived quantitative measurements between ULDCT and SDCT for assessing residual tiny fragments and dust after laser lithotripsy.</p> Materials and methods <p>Ex vivo porcine kidney models were implanted with human renal stones categorized as small fragments (2.00–2.36&#xa0;mm), tiny fragments (1.00–1.40&#xa0;mm), and dust (≤ 250&#xa0;μm). Utilizing ULDCT and SDCT, stone volume, maximum and mean attenuation values, and the standard deviation of attenuation values were automatically quantified with volume analyzer software. ULDCT was conducted with a radiation dose equivalent to 1 millisievert.</p> Results <p>CT characteristics obtained with ULDCT were comparable to those obtained with SDCT for detecting small stones (<i>p</i> &gt; 0.05) and for differentiating dust from larger fragments, whereas significant differences in these characteristics were observed among the stone categories (<i>p</i> &lt; 0.001).</p> Conclusion <p>In this ex vivo study, ULDCT provided quantitative CT characteristics comparable to those obtained with SDCT for very small stones, including dust. These findings support its potential utility for postoperative assessment after laser lithotripsy, although clinical in vivo validation is warranted.</p>

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Efficacy of 1 mSv ultra-low-dose CT with automated volume analyzer software for detecting residual tiny fragments and dust particles after laser lithotripsy: an ex vivo Phantom study

  • 期刊论文

  • 发表日期：

    2026年2月16日

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  • Naoto Tanaka,
  • Akash Chitrakar,
  • Satoshi Kitamura,
  • Daiki Katsura,
  • Fukashi Yamamichi,
  • Yasuhiro Kaku,
  • Yosuke Fukiishi,
  • Masaichiro Fujita,
  • Takaaki Inoue

摘要

Background and objectives

Radiation exposure remains a major concern for patients with urolithiasis who undergo frequent imaging for diagnosis, treatment, and follow-up. The dusting technique generates numerous small-sized fragments and dust particles, some of which remain in the kidney as residual stones. Although ultra-low-dose computed tomography (ULDCT) has demonstrated comparable performance to standard-dose computed tomography (SDCT) for detecting urinary stones above a certain size, its utility in detecting very small stones (< 2–3 mm) has not been thoroughly investigated. This study aimed to evaluate the comparability of CT-derived quantitative measurements between ULDCT and SDCT for assessing residual tiny fragments and dust after laser lithotripsy.

Materials and methods

Ex vivo porcine kidney models were implanted with human renal stones categorized as small fragments (2.00–2.36 mm), tiny fragments (1.00–1.40 mm), and dust (≤ 250 μm). Utilizing ULDCT and SDCT, stone volume, maximum and mean attenuation values, and the standard deviation of attenuation values were automatically quantified with volume analyzer software. ULDCT was conducted with a radiation dose equivalent to 1 millisievert.

Results

CT characteristics obtained with ULDCT were comparable to those obtained with SDCT for detecting small stones (p > 0.05) and for differentiating dust from larger fragments, whereas significant differences in these characteristics were observed among the stone categories (p < 0.001).

Conclusion

In this ex vivo study, ULDCT provided quantitative CT characteristics comparable to those obtained with SDCT for very small stones, including dust. These findings support its potential utility for postoperative assessment after laser lithotripsy, although clinical in vivo validation is warranted.