Analysis of urinary stone components by x-ray coherent scatter: characterizing composition beyond laboratory x-ray diffractometry.

Monoenergetic x-ray diffraction (XRD) analysis is an established standard for the assessment of urinary stone composition. The inherent low energy of x-rays used (8 keV), however, restricts penetration depth and imposes a requirement for small powdered samples. A technique capable of producing detailed information regarding component structural arrangements in calculi non-destructively would provide clearer insights into causes of formation and subsequent growth and allow the selection of more appropriate courses of therapy. We describe a new method based on the detection of coherent scatter (CS) in stone components using polyenergetic x-rays (70 kVp) from diagnostic equipment. While the higher energy allows the analysis of intact calculi, the polyenergetic source causes an angular broadening of measured CS patterns. We show that it is possible to relate the polyenergetic (CS) and monoenergetic (XRD) measurements through a superposition integral of the monoenergetic XRD cross-section with a function representative of the polyenergetic spectrum used in CS. Experimentally acquired diffractometry cross-sections of the seven major urinary stone components were subjected to this operation, revealing good agreement of diffraction features with CS. Therefore, our CS analysis is sensitive to stone component structure, similar to conventional XRD analysis. This indicates that CS analysis can be used as a basis to classify urinary calculi by composition. The potential of identifying stone components non-destructively was demonstrated from a tomographic CS analysis of a stone-mimicking phantom. Tomographic composition maps were generated from CS patterns, showing the structural arrangement of multiple stone components within the phantom. CS analysis has the ability to detect components in the presence of many others. The ability to perform CS measurements in intact calculi would allow for the identification of stone structures critical to patient metaprophylaxis.