ArticleEuropean journal of medical research2026
Dual-source CT for medical dissolution of uric acid stones: a retrospective derivation and prospective validation study.
Article in European journal of medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study aimed to prospectively assess whether dual-source CT‑guided identification of uric acid stones can effectively direct patients to successful medical dissolution therapy.
methodsA retrospective diagnostic study of 760 patients with urinary stones was conducted. Preoperative dual-source CT parameters were compared with postoperative infrared spectroscopy to establish diagnostic cut-off values. In the prospective intervention study, 60 patients with uric acid stones-identified by a dual-energy ratio ≤ 1.15 on dual-source CT-were randomized to an experimental group (stone dissolution therapy with sodium potassium hydrogen citrate plus lifestyle guidance) or a control group (lifestyle guidance only). Treatment outcomes were evaluated at 3 months.
resultsIn the retrospective cohort, dual-source CT demonstrated excellent diagnostic accuracy for uric acid stones, with an area under the curve of 0.998 for the dual-energy ratio. Optimal cut-offs were as follows: dual-energy ratio ≤ 1.165, attenuation at 100 kV < 641.5 HU, and attenuation at 150 kV < 570.5 HU. In the prospective trial, the experimental group achieved significantly higher complete dissolution rates (80% vs. 20%), lower non-response rates (3.3% vs. 33.3%), and lower surgical rates (3.3% vs. 30%). Urine pH improved in the experimental group without significant change in serum uric acid.
conclusionDual-source CT accurately identifies uric acid stones using a dual-energy ratio threshold of ≤1.15, enabling targeted medical therapy. This imaging-guided strategy significantly improves stone dissolution outcomes and reduces the need for surgical intervention.
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