StoneChecker is an innovative medical software tool designed to aid clinical decision making by providing information about a patient’s kidney stone. The StoneChecker software tool is designed to be a streamlined semi-automated stone assessment tool that instantly provides physicians with useful clinical metrics using the patient’s non-contrast CT scans.

Stone Checker Software Ltd. has an exclusive worldwide licence to apply the TexRAD® algorithm to examine heterogeneity and ‘texture’ not visible to the naked eye. Tested and validated at the University of Oxford, StoneChecker software has been available worldwide for research use since 2017 and is currently available for commercial use in the United States, European Union, and South Korea.


The team at Stone Checker Software Ltd has developed an application based on the TexRAD algorithm which analyses various physical attributes of a given renal stone on non-contrast enhanced CT scan slices and prepares a report. The analysis examines physical characteristics of the stone including volume, mean HU density, skin-to-stone distance, entropy, kurtosis, and skewness. Each of these factors in separate non-clinical and in-vivo studies have shown to be relevant in predicting stone-free rates and the outcome of lithotripsy procedure performed on the stone.

The Texrad Algorithm

Diagnostic imaging systems e.g. Computed Tomography (CT) have generally enhanced fine detail (i.e. high spatial frequency information) with the aim of optimising anatomical resolution.

TexRAD’s patented proprietary filtration-histogram algorithm highlights coarser features on CT and uses histogram analysis to quantify and assess the distribution of grey-levels, coarseness and regularity within a region of interest e.g. kidney stone. By using filters that extract and enhance image features at larger scales, the effect of noise is reduced whilst heterogeneity in stone architecture is enhanced.

TexRAD allows heterogeneity parameters measured at different spatial scales to enable quantitative assessment of imaging biomarkers within kidney stones which can potentially be used to identify treatment failure on pre-treatment CT and also assess the stone composition non-invasively.

TexRAD has been licenced by TexRAD Ltd.,, part of Feedback plc, Cambridge UK, to Stone Checker Software Ltd. for exclusive use in urolithiasis.


CT Texture Analysis (CTTA) metrics reflected stone characteristics and composition, and predicted ease of SWL fragmentation. The strongest correlation with number of shocks required to fragment the stone was mean Hounsfield unit (HU) density (r = 0.806, p = 0.028) and a CTTA metric measuring the entropy of the pixel distribution of the stone image (r = 0.804, p = 0.039). Using multiple linear regression analysis, the best model showed that CTTA metrics of entropy and kurtosis could predict 92% of the outcome of number of shocks needed to fragment the stone. This was superior to using stone volume or density.


Key StoneChecker publications:

CT Texture Analysis of Ex Vivo Renal Stones Predicts Ease of Fragmentation with Shockwave Lithotripsy

Cui Helen W., Devlies Wout, Ravenscroft Samuel, Heers Hendrik, Freidin Andrew J., Cleveland Robin O., Ganeshan B, and Turney Benjamin W.. Journal of Endourology. July 2017, 31(7): 694-700.

Differentiating Uric acid vs non-uric acid stones

Clin Radiol. 2018 May 21.

G.-M.-Y. Zhang, H. Sun, B. Shi, M. Xu, H.-D. Xue, Z.-Y. Jin

Predicting failure of lithotripsy treatment

Helen Cui - Oxford, United Kingdom, Mafalda Silva - Lisboa, Portugal, Gumuyang Zhang, Bing Shi, Hao Sun, Zhengu Jin Beijing, China, People's Republic of Bernard V North Belfast, United Kingdom, Balaji Ganeshan London, United Kingdom, Benjamin Turney Oxford, United Kingdom

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