PD37-10 RADIATION EXPOSURE FROM CT SCANS FOR UROLITHIASIS: RESULTS FROM THE REGISTRY FOR STONES OF THE KIDNEY AND URETER (RESKU)

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology III1 Apr 2018PD37-10 RADIATION EXPOSURE FROM CT SCANS FOR UROLITHIASIS: RESULTS FROM THE REGISTRY FOR STONES OF THE KIDNEY AND URETER (RESKU) David T. Tzou, Manint Usawachintachit, Samuel Zetumer, Kazumi Taguchi, Dylan Isaacson, Shalonda Reliford-Titus, Benjamin A. Sherer, Marshall L. Stoller, and Thomas Chi David T. TzouDavid T. Tzou More articles by this author , Manint UsawachintachitManint Usawachintachit More articles by this author , Samuel ZetumerSamuel Zetumer More articles by this author , Kazumi TaguchiKazumi Taguchi More articles by this author , Dylan IsaacsonDylan Isaacson More articles by this author , Shalonda Reliford-TitusShalonda Reliford-Titus More articles by this author , Benjamin A. ShererBenjamin A. Sherer More articles by this author , Marshall L. StollerMarshall L. Stoller More articles by this author , and Thomas ChiThomas Chi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1745AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients with kidney stones routinely have computed tomography (CT) scans as part of their diagnostic workup. The recommended yearly dose limit for occupational radiation exposure by the International Commission on Radiological Protection is 50 mSv, yet how often this limit is exceeded for stone patients remains unknown. Radiation exposure beyond this limit may impart long-term risks of secondary malignancies. This study aimed to identify annual effective radiation doses received by consecutive stone patients referred to a tertiary care stone clinic. METHODS From October 2015 to March 2017, new stone patients were prospectively enrolled into the Registry for Stones of the Kidney and Ureter - ReSKU at the University of California San Francisco (UCSF) for this cohort study. For each patient, all available CT scans of the abdomen/pelvis done prior to their initial visit were reviewed. Measures of radiation exposure such as volume CT dose index (CTDIvol) and dose-length-product (DLP) were recorded. Effective dose (ED) was calculated by multiplying the DLP by a validated conversion factor (0.015), appropriate for a CT abdomen/pelvis. Univariate and multivariate regression analyses were performed to determine factors associated with patient ED, and a logistic model was used to dichotomize patients receiving >50mSv/year cumulative ED. RESULTS Of 594 patients enrolled into ReSKU, 458 patients had ≥ 1 CT abdomen/pelvis available for review. CT scans were performed at 135 unique radiologic centers. Only 5.5% of the 819 CT scans performed met criteria for a low dose CT scan (ED <4 mSv). There were 33 patients (7.2%) who received an ED >50 mSv/year (mean 77 mSv, range 51 to 210 mSv). Univariate logistic analysis demonstrated a statistically significant association of body mass index (BMI) (OR 1.1), number of scans (OR 3.8), performing location (OR 2.6), and multi-phase scans (OR 3.7) with patients receiving a >50mSv/year cumulative ED (p<0.01), respectively. Multivariate linear regression analysis revealed that high BMI, multi-phase scans, and number of scans was associated with higher ED (p<0.01). CONCLUSIONS A subset of kidney stone patients continue to receive dangerous ionizing radiation exposure from CT scans. Higher effective dose was associated with patients who had higher BMI, multi-phase CT scans, and a higher number of scans performed. All practitioners should be cognizant of the amount of radiation received by kidney stone patients and continued efforts to utilize low-dose CT protocols should be a priority within the medical community. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e734-e735 Advertisement Copyright & Permissions© 2018MetricsAuthor Information David T. Tzou More articles by this author Manint Usawachintachit More articles by this author Samuel Zetumer More articles by this author Kazumi Taguchi More articles by this author Dylan Isaacson More articles by this author Shalonda Reliford-Titus More articles by this author Benjamin A. Sherer More articles by this author Marshall L. Stoller More articles by this author Thomas Chi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...