1710 ASSESSMENT OF RADIATION EXPOSURE FROM DIAGNOSTIC IMAGING IN PATIENTS UNDERGOING URETEROSCOPY WITH LASER LITHOTRIPSY FOR UPPER TRACT STONES

Abstract

You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal II1 Apr 20121710 ASSESSMENT OF RADIATION EXPOSURE FROM DIAGNOSTIC IMAGING IN PATIENTS UNDERGOING URETEROSCOPY WITH LASER LITHOTRIPSY FOR UPPER TRACT STONES Brooke Harnisch, Jessica Kreshover, Aylin Bilgutay, Richard Babayan, and David Wang Brooke HarnischBrooke Harnisch Boston, MA More articles by this author , Jessica KreshoverJessica Kreshover Boston, MA More articles by this author , Aylin BilgutayAylin Bilgutay Boston, MA More articles by this author , Richard BabayanRichard Babayan Boston, MA More articles by this author , and David WangDavid Wang Boston, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1647AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients with urolithiasis who undergo ureteroscopy with laser lithotripsy are commonly diagnosed with computed tomography scanning, plain X-ray, and renal ultrasound. However, there has been recent concern that patients with urolithiasis are at increased risk for radiation exposure above the recommended annual limit of 50 milliSieverts (mSv) due to diagnostic imaging, especially with CT scan. Therefore, the aim of this study was to evaluate the number of imaging studies and the amount of radiation exposure to patients undergoing ureteroscopy for upper tract stones. METHODS An institutional review board (IRB) approved retrospective study was conducted on all patients who underwent ureteroscopy for upper tract stones between 2003 and 2007. Patients receiving surveillance imaging studies for other disease entities were excluded. Total number of imaging studies was analyzed over a total of 1-14 months. Time period of data collection was determined from the initial diagnosis of the stone until 6 weeks following completion of ureteroscopy. Radiation dose was calculated using effective radiation dose standards for each of these examinations. RESULTS A total of 284 patients were identified. Mean size of stone was 8.71 ± 4.2 mm. The most common stone location was renal (43%) followed by distal/mid ureter (35%) and proximal ureter (22%). Patients underwent an average of 1.6 CT scans of the abdomen/pelvis (range 0 to 6) and 2.2 plain abdominal films of the kidney, ureters and bladder (KUB) (range 0 to 14) over an average of 5 months. The median total effective dose per patient was 36.1 mSV. There were 124 patients (43%) who received ≥ 50mSv which is equivalent to ≥ 2 CT scans. Factors associated with receiving ≥ 2 CT scans are shown in table 1. Table 1. Factors associated with receiving ≥ 2 CT scans P value Initial imaging completed at outside hospital 0.85 Type of intervention (unilateral URS vs. bilateral URS) 1.00 Stone size 0.08 Stone location 0.02 Presence of stent 1.00 Post surgical complications 0.13 CONCLUSIONS A large percentage of patients (43%) received > 50mSv of radiation in a one year time frame. Smaller size and mid/distal location of the stone significantly increased the risk of receiving a higher number of imaging studies. This study emphasizes the increased radiation risk to patients with urolithiasis and the importance of using alternative imaging modalities for these patients. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e690 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Brooke Harnisch Boston, MA More articles by this author Jessica Kreshover Boston, MA More articles by this author Aylin Bilgutay Boston, MA More articles by this author Richard Babayan Boston, MA More articles by this author David Wang Boston, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...