MP36-14 ARE UROLITHIASIS PATIENTS REALLY EXPOSED TO MORE RADIATION WITH CT KUBS THAN PLAIN ABDOMINAL RADIOGRAPHS?

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology I (MP36)1 Apr 2020MP36-14 ARE UROLITHIASIS PATIENTS REALLY EXPOSED TO MORE RADIATION WITH CT KUBS THAN PLAIN ABDOMINAL RADIOGRAPHS? Bob Yang*, Noorunisa Suhail, Johan Marais, Thomas Reeves, Mostafa Ragab, Alister Campbell, Mohammed ElSaghir, Melissa Davies, and James Brewin Bob Yang*Bob Yang* More articles by this author , Noorunisa SuhailNoorunisa Suhail More articles by this author , Johan MaraisJohan Marais More articles by this author , Thomas ReevesThomas Reeves More articles by this author , Mostafa RagabMostafa Ragab More articles by this author , Alister CampbellAlister Campbell More articles by this author , Mohammed ElSaghirMohammed ElSaghir More articles by this author , Melissa DaviesMelissa Davies More articles by this author , and James BrewinJames Brewin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000880.014AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urolithiasis patients often require frequent urinary tract imaging, leading to high radiation exposure. CT Kidney-Ureter-Bladder (CT-KUB) is the gold standard in urolithiasis detection, however is commonly thought to harbour significant radiation load. Urologists have therefore utilised abdominal radiographs (XR-KUB) as an alternative, though with markedly lower sensitivity and specificity. Historical guidelines state the Effective-Dose of XR-KUBs at 0.8mSv, however no contemporary UK data exists comparing this with the current gold standard low dose CT-KUBs. We compared the radiation Effective-Dose (mSv) of XR-KUBs and low dose CT-KUBs. METHODS: 53 patients were retrospectively identified who underwent both a XR-KUB and a low dose CT-KUB in 2018. Effective-Dose (utilised as a numerical measure of overall risk to a patient from imaging modalities) was measured by converting the recorded “Dose Area/Length Product” via the standardised ICRP formula. RESULTS: The average Effective-Dose for XR-KUBs was 5.10mSv [Range:0.8-42.4]. CT-KUBs was 5.31mSv [Range:1.4–30.5]. 18/53 (34%) of patients underwent XR-KUBs with higher Effective-Dose levels than their CT-KUB. Patients with higher Weight, BMI and AP diameter had higher Effective-Doses for both their XR and CT-KUBs. Patients weighing more than 92kg or had a BMI greater than 32 all had a XR-KUBs with a higher Effective-Dose than their CT-KUB. CONCLUSIONS: For the first time in the UK, we have found that the Effective-Dose of XR-KUB was on average 5-fold higher than historically referenced. Furthermore, for 1-in-3 patients, the radiation Effective-Dose of their CT-KUBs was less than their XR-KUB. This is particularly true in patients with BMI over 32 and weight over 92kg. Given the higher than expected radiation dose associated with XR-KUBs and its’ limited sensitivity/considering alternative imaging modalities such as Ultrasound-KUB or the implementation of “ultra-low dose” CT KUBs where the Effective-Dose is reported to be as low as 1.9 mSv. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e528-e528 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bob Yang* More articles by this author Noorunisa Suhail More articles by this author Johan Marais More articles by this author Thomas Reeves More articles by this author Mostafa Ragab More articles by this author Alister Campbell More articles by this author Mohammed ElSaghir More articles by this author Melissa Davies More articles by this author James Brewin More articles by this author Expand All Advertisement PDF downloadLoading ...