Symptomatic urinary stone disease affects approximately 900,000 persons in the United States each year, resulting in an estimated annual medical cost of $4.5 billion. Computed tomography (CT) is the established method for imaging urinary calculi and can provide accurate sub-millimeter details of the size and location of renal stones. However, a complete characterization of renal stones, which includes stone composition and fragility, is critically needed for safe and cost effective management of stone disease, as well as for phenotyping of research subjects. Our long term goal is to use advanced CT methodologies to fully characterize urinary calculi, and to use evolving technology to reliably detect stone precursor lesions. Our objectives in this application are to develop a comprehensive, low-dose, stone-characterization exam using commercially-available dual-energy CT technology, and to detect stone precursor lesions using a prototype CT system equipped with energy resolving detectors. Based on our extensive preliminary results, we know that dual-energy CT can discriminate between several types of renal stones and provide accurate quantification of stone morphology. Our central hypothesis is that this quantitative information can be acquired at reduced dose levels and used to predict stone fragility, which we define as the likelihood of a stone to be broken by SWL or endoscopic methods. We further hypothesize that use of pre-clinical, 225-micron, energy-resolving CT detectors will allow detection of stone precursor lesions such as Randall's plaques, as well as the presence of trace elements having a suspected role in stone formation, such as zinc. We will accomplish these objectives through two specific aims: 1) Aim 1: Develop and validate a comprehensive low-dose stone-characterization exam using clinical dual-energy CT techniques. 2) Aim 2: Develop a pre-clinical spectral CT imaging technique that can detect precursor lesions and trace elements related to the formation of kidney stones.

Public Health Relevance

This proposal will develop imaging techniques that can determine urinary stone type and fragility in patients. The significance of this is that these advanced CT imaging techniques will allow physicians to more efficiently direct patient therapy and perform clinical research, potentially avoiding procedures associated with higher risk or cost.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
5U54DK100227-02
Application #
8734909
Study Section
Special Emphasis Panel (ZDK1-GRB-9)
Project Start
Project End
Budget Start
2014-07-01
Budget End
2015-06-30
Support Year
2
Fiscal Year
2014
Total Cost
$157,523
Indirect Cost
$46,069
Name
Mayo Clinic, Rochester
Department
Type
DUNS #
006471700
City
Rochester
State
MN
Country
United States
Zip Code
55905
Moen, Taylor; Ferrero, Andrea; McCollough, Cynthia (2018) Robustness of Textural Features to Predict Stone Fragility Across Computed Tomography Acquisition and Reconstruction Parameters. Acad Radiol :
Abd El-Salam, Mohamed; Bastos, Jairo Kenupp; Han, Jing Jing et al. (2018) The Synthesized Plant Metabolite 3,4,5-Tri-O-Galloylquinic Acid Methyl Ester Inhibits Calcium Oxalate Crystal Growth in a Drosophila Model, Downregulates Renal Cell Surface Annexin A1 Expression, and Decreases Crystal Adhesion to Cells. J Med Chem 61:1609-1621
Sivaguru, Mayandi; Saw, Jessica J; Williams Jr, James C et al. (2018) Geobiology reveals how human kidney stones dissolve in vivo. Sci Rep 8:13731
Shah, Ronak Jagdeep; Lieske, John C (2018) Inching toward a Greater Understanding of Genetic Hypercalciuria: The Role of Claudins. Clin J Am Soc Nephrol 13:1460-1462
Ruetten, Hannah; Wegner, Kyle A; Romero, Michael F et al. (2018) Prostatic collagen architecture in neutered and intact canines. Prostate 78:839-848
Marcus, Roy P; Fletcher, Joel G; Ferrero, Andrea et al. (2018) Detection and Characterization of Renal Stones by Using Photon-Counting-based CT. Radiology 289:436-442
Ferrero, Andrea; Gutjahr, Ralf; Halaweish, Ahmed F et al. (2018) Characterization of Urinary Stone Composition by Use of Whole-body, Photon-counting Detector CT. Acad Radiol 25:1270-1276
Vaughan, Lisa E; Enders, Felicity T; Lieske, John C et al. (2018) Predictors of Symptomatic Kidney Stone Recurrence After the First and Subsequent Episodes. Mayo Clin Proc :
Kittanamongkolchai, Wonngarm; Vaughan, Lisa E; Enders, Felicity T et al. (2018) The Changing Incidence and Presentation of Urinary Stones Over 3 Decades. Mayo Clin Proc 93:291-299
Dhondup, Tsering; Kittanamongkolchai, Wonngarm; Vaughan, Lisa E et al. (2018) Risk of ESRD and Mortality in Kidney and Bladder Stone Formers. Am J Kidney Dis 72:790-797

Showing the most recent 10 out of 100 publications