Abstract
Background and Purpose
: The choice of the most efficient treatment modality for renal calculi could be facilitated by determining the precise chemical stone composition before treatment. We investigated the possibility of using conventional X-ray imaging to determine stone composition and to find a simple method of predicting stone fragility for treatment planning.
Materials and Methods
: The X-ray density of 92 stones with known infrared spectroscopy analyses (calcium oxalate monohydrate, calcium oxalate dihydrate, struvite, and calcium phosphate) was retrospectively investigated by scanning the films with a digital camera. The data analysis was done using a commercially available graphics program to compare the total gray-scale levels of the stones.
Results
: There was a significant difference in the mean gray-scale level of calcium phosphate and calcium oxalate stones (P < 0.01). The mean gray-scale difference between calcium oxalate dihydrate and calcium oxalate monohydrate was also significant (p < 0.02). All calcium oxalate, struvite, and calcium phosphate stones were correctly identified. Of the calcium oxalate monohydrate and calcium oxalate dihydrate stones, 98.4% and 66.6%, respectively, were correctly identified.
Conclusion
: The method allows a reliable diagnosis of stone composition from radiographs, which can be useful in stone treatment planning.
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