Visualisation of uric acid renal calculi (UARC) using computed radiography (CR)

Abstract 

Aim

To investigate the capability of CR to visualise UARC through inverse image post-processing technique.

Methods. A patient-equivalent phantom (PEP) consisting of six 2.5-cm thick Perspex layers and one 1-mm thick aluminium layer was used to represent human tissues and bones respectively. A total of eight exposures were made on PEP to radiograph 1mm, 2mm and 3mm UARC located between three layers of 2-cm thick cattle muscle, positioned inside the PEP. After each exposure, a layer of Perspex was removed, and another exposure was made until only one Perspex layer and one layer of muscle (containing the three UARC) remained. For each exposure, two images (a positive and an inverse image) were produced for comparison using Fuji XG1 computed radiography system with IP0 type C-ST-VI Fuji imaging plate (equivalent to 400 speed radiographic screen-film systems).

Results

In positive image, UARC of all three sizes (1mm, 2mm and 3mm) located in the cattle muscle, cannot be visualised when the PEP consists of more than one layer of Perspex. In inverse image, the 3-mm UARC can be seen even when the PEP consists of five layers of Perspex.

Conclusion

This study revealed the post-processing capability of CR to increase the visualisation of UARC which has been categorised as radiolucent. A further study of clinical image quality should be performed using blinded observers to test diagnostic accuracy, which was not included in this study.

Keywords: Uric acid renal calculi, Radiolucent, Computed radiography, Inverse image