1948 ORGAN SPECIFIC RADIATION DOSE RATES AND EFFECTIVE DOSE DURING PERCUTANEOUS NEPHROLITHOTOMY

Abstract

You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal IV1 Apr 20121948 ORGAN SPECIFIC RADIATION DOSE RATES AND EFFECTIVE DOSE DURING PERCUTANEOUS NEPHROLITHOTOMY Michael Lipkin, John Mancini, Agnes Wang, Greta Toncheva, Colin Anderson-Evans, Michael Ferrandino, Terry Yoshizumi, and Glenn Preminger Michael LipkinMichael Lipkin Durham, NC More articles by this author , John ManciniJohn Mancini Durham, NC More articles by this author , Agnes WangAgnes Wang Durham, NC More articles by this author , Greta TonchevaGreta Toncheva Durham, NC More articles by this author , Colin Anderson-EvansColin Anderson-Evans Durham, NC More articles by this author , Michael FerrandinoMichael Ferrandino Durham, NC More articles by this author , Terry YoshizumiTerry Yoshizumi Durham, NC More articles by this author , and Glenn PremingerGlenn Preminger Durham, NC More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2106AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Fluoroscopy time has been used to report on radiation exposure during urologic procedures. However, it is difficult to determine actual radiation dose delivered to patients based on fluoroscopy time. Effective dose relates absorbed radiation to the risk of developing a malignancy. We determined organ specific dose rates and calculated effective dose rates (EDR) during right and left sided percutaneous nephrolithotomy (PNL) using a validated phantom model. We determined effective dose (ED) for right and left PNL performed at our institution. METHODS A validated anthropomorphic adult male phantom was placed prone on an operating room table. Metal Oxide Semiconductor Field Effect Transistor dosimeters were placed at 20 organ locations to measure the organ dosages. A portable C-arm was used to provide continuous fluoroscopy for three 10 minute runs each to simulate a left and right PNL. Organ dose rate (mGy/s) was determined by dividing organ dose by fluoroscopy time. The organ dose rates were multiplied by their tissue weighting factor and summed to determine EDR (mSv/s). We retrospectively reviewed 210 PNL procedures performed at our institution over a two year period. A total of 20 procedures on non-obese males with information on fluoroscopy time were included. Non-obese males most closely match the physical characteristics of our model. The ED was calculated by multiplying the fluoroscopy time by the EDR. RESULTS The EDR for a left and right sided PNL were 0.021 mSv/s and 0.014 mSv/s, respectively. The skin entrance was exposed to the greatest amount of radiation during left and right PNL, 0.24 mGy/s and 0.26 mGy/s respectively. The stomach was exposed to the second greatest amount of radiation on the left (0.07 mGy/s) and the gallbladder was exposed to the second greatest amount of radiation on the right (0.12 mGy/s). The median fluoroscopy time and ED for left PNL were 386.3 s (142.2–1364.6) and 8.11 mSv (2.99–28.66). The median fluoroscopy time and ED for a right PNL were 545.0 s (236.8–1269.5) and 7.63 mSv (3.32–17.77). CONCLUSIONS The EDR is higher for a left sided PNL compared to a right sided PNL. This is due to the fact that distribution of radiation exposure during PNL is not uniform. The patient ED for left and right PNL in non-obese males is greater than that of a computed tomography of the abdomen/pelvis. This radiation contributes to the overall amount patients with stones are exposed to. Further studies are needed to determine ways to reduce radiation exposure during PNL. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e786 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Lipkin Durham, NC More articles by this author John Mancini Durham, NC More articles by this author Agnes Wang Durham, NC More articles by this author Greta Toncheva Durham, NC More articles by this author Colin Anderson-Evans Durham, NC More articles by this author Michael Ferrandino Durham, NC More articles by this author Terry Yoshizumi Durham, NC More articles by this author Glenn Preminger Durham, NC More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...