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2016 ; 57
(2
): 113-7; discussion 118
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Radiation dosing in the investigation and follow-up of urolithiasis: Comparison
between historical and contemporary practices
#MMPMID26981593
O'Kane D
; D'Arcy FT
; Papa N
; Smith N
; McClintock S
; Lawrentschuk N
; Bolton DM
Investig Clin Urol
2016[Mar]; 57
(2
): 113-7; discussion 118
PMID26981593
show ga
PURPOSE: Computed tomography (CT) is the gold standard imaging modality for the
diagnosis and follow-up of urolithiasis. Before the use of CT, intravenous
urography (IVU) was the imaging modality of choice. CT remains contentious
because of the cancer risk related to radiation exposure above a threshold level.
We aimed to compare the radiation exposure dose to the average patient with
urolithiasis in the era of CT with that of IVU. MATERIALS AND METHODS: Our
hospital medical records database was searched for patients who presented to the
Emergency Department over a 1-month period in 1990 with a diagnosis of renal
colic. Patients with the same presentation, from the same month, in 2013 were
also identified. A total of 14 patients from each year fulfilled the inclusion
criteria. The estimated effective radiation exposure dose for each patient was
calculated by using data from population-based studies. RESULTS: The median
effective radiation dose per patient in the 1990 group, for initial diagnosis and
subsequent follow-up, was 4.05 mSv (interquartile range [IQR], 3.7-4.4 mSv). The
corresponding median dose in the 2013 group was 4.2 mSv (IQR, 4.2-4.9 mSv), and
there was no evidence of a statistical difference between the groups (p=0.8).
CONCLUSIONS: Despite the contentiousness related to the use of serial CT
scanning, our study demonstrated that for radiological investigation and
follow-up of urolithiasis, the estimated effective radiation exposure dose to
each patient is only marginally higher than in the era of IVU, with improvements
in length of hospital stay and time to definitive diagnosis.
|*Radiation Dosage
[MESH]
|Adult
[MESH]
|Databases, Factual
[MESH]
|Humans
[MESH]
|Length of Stay/statistics & numerical data/trends
[MESH]