No. 6. Automated Measurement of Stone Heterogeneity Index and Variation Coefficient of Stone Density on CT Image Manuscript Received: 16 February 2023, Accepted: 13 March 2023, Published: 15 March 2023, ORCiD: 0009-0000-1482-4471

Main Article Content

Lai Yee Myint
Khine Thin Zar


Heterogeneity is a key feature of stone density as Hounsfield Unit (HU) on computer tomography (CT) for extracorporeal shock-wave lithotripsy (ESWL) outcomes predicting in urinary calculi patients. The goal of this study is to develop the modified 2D and 3D automate stone heterogeneity index and variation coefficient of stone density estimation program to predict ESWL treatment. For 2D, the proposed program was selected the largest slice of the stone in the whole input slice and then stone related variables, stone heterogeneity index and variation coefficient of stone density were calculated by using the average HU and the number of voxels of the stone. For these variables, it was also developed 3D automate system by using all slices including the stone. Moreover, the 2D schematic diagram was produced to show the internal structure of stone in order to estimate the compositional heterogeneity of stone.  All processes of this study were established without manual process. And then, the result of the proposed study is presented compared with the manual measurements.  The described methods can provide to assist the prediction of ESWL treatment success and urinary stone diagnosis.

Article Details



J. Y. Lee, J. H. Kim, D. H. Kang, D. Y. Chung, D. H. Lee and H. Do, “Stone Heterogeneity Index as The Standard Deviation of Hounsfield Units: A Novel Predictor for Shock-Wave Lithotripsy Outcomes in Ureter Calculi,” Sci. Rep., vol. 6, no. 23988, pp. 1–7, 2016.

S. Yamashita, Y. Kohjimoto, Y. Iwahashi, T. Iguchi, S. Nishizawa, K. Kikkawa and I. Hara, “Noncontrast Computed Tomography Parameters for Predicting Shock Wave Lithotripsy Outcome in Upper Urinary Tract Stone Cases,” Biomed Res. Int., vol. 2018, no. 9253952, pp. 1-6, 2018.

H. Singh, D. Gayen, T. K. Mandal and K. Maiti, “The Efficacy of Hounsfield Unit Density of Renal Calculi in Predicting The Success of ESWL,” Sch. Acad. J. Biosci., vol. 4, no. 5, pp. 385-389, 2016.

W. Finch, R. Johnston, N. Shaida, A. Winterbottom and O. Wiseman, “Measuring Stone Volume - Three-dimensional Software Reconstruction or An Ellipsoid Algebra Formula?,” BJU Int., vol. 113, no. 4, pp. 610–614, 2014.

S. Ebrahimi and V. Y. Mariano, “Image Quality Improvement in Kidney Stone Detection on Computed Tomography Images,” J. Image Graph., vol. 3, no. 1, pp. 40–46, 2015.

R. E. Jacob and J. P. Carson, “Automated Measurement of Heterogeneity in CT Images of Healthy and Diseased Rat Lungs Using Variogram Analysis of An Octree Decomposition,” Jacob Carson BMC Med. Imaging, vol. 14, no. 1, pp. 1–11, 2014.

C. Oktay, M. Corapli and A. Tutus, “The Usefulness of The Hounsfield Unit And Stone Heterogeneity Variation in Predicting The Shockwave Lithotripsy Outcome,” Diagnostic Interv. Radiol., vol. 28, no. 3, pp. 187–192, 2022.

K. Krechetova, A. Glaz and A. Platkajis, “3D Medical Image Visualization and Volume Estimation of Pathology Zones,” IFMBE Proc., vol. 20, pp. 532–535, 2008.

N. Thein, T. B. Adji, K. Hamamoto, and H. A. Nugroho, “Automated false positive reduction and feature extraction of kidney stone object in 3D CT images,” Int. J. Intell. Eng. Syst., vol. 12, no. 2, pp. 62–73, 2019, doi: 10.22266/IJIES2019.0430.07.

N. Iqbal, A. Hasan, A. Nazar, S. Iqbal, M. H. Hassan and B. S. Gill, “Role of Stone Heterogeneity Index in Determining Success of Shock Wave Lithotripsy in Urinary Calculi,” J. Clin. Transl. Res., vol. 7, no. 2, pp. 241–247, 2021.

N. Fenton and M. Neil, “Correlation Coefficient and P-Values: What They Are and Why You Need To Be Very Wary of Them,” Risk Assess. Decis. Anal. with Bayesian Networks, 2012. [Online]. Available:

H. Y. Kim, “Analysis of Variance (ANOVA) Comparing Means of More Than Two Groups,” Restor. Dent. Endod., vol. 39, no. 1, pp. 74-77, 2014.