Development of a radiomics model to discriminate ammonium urate stones from uric acid stones in vivo:A remedy for the diagnostic pitfall of dual-energy computed tomography

作     者：Junjiong Zheng Jie Zhang Jinhua Cai Yuhui Yao Sihong Lu Zhuo Wu Zhaoxi Cai Aierken Tuerxun Jesur Batur Jian Huang Jianqiu Kong Tianxin Lin 

作者机构：Department of UrologySun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene RegulationGuangdong Provincial Clinical Research Center for Urological DiseasesGuangzhouGuangdong 510120China Department of NeurologySun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhouGuangdong 510120China Department of RadiologySun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhouGuangdong 510120China Department of UrologyThe First People’s Hospital of Kashgar PrefectureKashgarXinjiang 844000China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2024年第137卷第9期

页      面：1095-1104页

核心收录：

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 100207[医学-影像医学与核医学] 1006[医学-中西医结合] 1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 08[工学] 1010[医学-医学技术（可授医学、理学学位）] 100106[医学-放射医学] 10[医学] 100602[医学-中西医结合临床] 

基　　金：supported by the China Postdoctoral Science Foundation(Nos.2021TQ0387,2022M713625,and 2021M703709) the National Natural Science Foundation of China(Nos.82203188 and 81825016) Guangdong Provincial Clinical Research Center for Urological Diseases(No.2020B1111170006) the Guangdong Basic and Applied Basic Research Foundation(No.2020A1515111119) 

主　　题：Ammonium urate Dual-energy scanned projection radiography Radiomics Uric acid Urolithiasis 

摘      要：Background:Dual-energy computed tomography(DECT)is purported to accurately distinguish uric acid stones from non-uric acid ***,whether DECT can accurately discriminate ammonium urate stones from uric acid stones remains ***,we aimed to explore whether they can be accurately identified by DECT and to develop a radiomics model to assist in distinguishing ***:This research included two *** the first purpose to evaluate the accuracy of DECT in the diagnosis of uric acid stones,178 urolithiasis patients who underwent preoperative DECT between September 2016 and December 2019 were *** model construction,93,40,and 109 eligible urolithiasis patients treated between February 2013 and October 2022 were assigned to the training,internal validation,and external validation sets,*** features were extracted from non-contrast CT images,and the least absolute shrinkage and selection operator(LASSO)algorithm was used to develop a radiomics ***,a radiomics model incorporating the radiomics signature and clinical predictors was *** performance of the model(discrimination,calibration,and clinical usefulness)was ***:When patients with ammonium urate stones were included in the analysis,the accuracy of DECT in the diagnosis of uric acid stones was significantly ***-two percent of ammonium urate stones were mistakenly diagnosed as uric acid stones by DECT.A radiomics model incorporating the radiomics signature,urine pH value,and urine white blood cell count was *** model achieved good calibration and discrimination{area under the receiver operating characteristic curve(AUC;95%confidence interval[CI]),0.944(0.899-0.989)},which was internally and externally validated with AUCs of 0.895(95%CI,0.796-0.995)and 0.870(95%CI,0.769-0.972),*** curve analysis revealed the clinical usefulness of the ***:DECT cannot accurately differentiate amm