The efficacy of tin-filtration for computed tomography in diagnosing urolithiasis

Sarah Li Hui Tan, Mohamed Badawy, Michal Schneider, Kenneth Kwok-Pan Lau, Keat Low, Peter Kutschera

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Introduction: The purpose of this study was to evaluate the radiation dose and image quality of computed tomography urograms (CTU) using tin-filtration compared to conventional CTU (without tin-filtration) examinations in patients with suspected urolithiasis. Methods: Group 1 consisted of 100 patients who were examined using the tin-filtered CTU protocols (Sn100kVp or Sn150kVp); Group 2 consisted of 100 patients who were examined using the same protocols but without tin-filtration (GE-NI41 or GE-NI43). The scanning protocol was based on the patients' body weight (<80 kg and ≥80 kg). The effective doses of all scans were compared between the two groups. Subjective image quality was evaluated by two blinded radiologists. The objective image quality was assessed for noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and figure-of-merit (FOM) using the CTU scans acquired from both the tin-filtered and non-tin-filtered protocols. Results: Tin-filtration resulted in the reduction of effective radiation dose ranging between 72% to 88% for the ≥80 kg and <80 kg patient groups respectively. For both groups, tin-filtration resulted in no significant differences in SNR and a significant increase in FOM. For the <80 kg group, tin-filtration resulted in significantly noisier images but with no significant difference in CNR. For the ≥80 kg group, tin-filtration resulted in significantly higher CNR. There was no significant difference in subjective image quality when assessed by the radiologists in terms of diagnostic confidence for urolithiasis. Conclusion: Tin-filtration significantly reduces patient dose while maintaining diagnostic image quality of CTUs for patients with suspected urolithiasis.

Original languageEnglish
Pages (from-to)126-131
Number of pages6
JournalClinical Imaging
Publication statusPublished - May 2019


  • Computed tomography
  • Radiation dose
  • Tin-filtration
  • Urogram
  • Urolithiasis

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