Endourology and StoneEffective Radiation Exposure in Evaluation and Follow-up of Patients With Urolithiasis
Section snippets
Material and Methods
A retrospective review was performed for consecutive patients presenting to a tertiary stone clinic with an acute stone episode between November 2007 and December 2008, and who had at least 2 years of follow-up. Patients who had imaging studies at outside institutions were excluded. Also, patients with CTs and fluoroscopy procedures that did not report an effective radiation dose and/or fluoroscopy time were excluded. The tertiary stone clinic is composed of 2 urologists, 2 nephrologists, a
Results
One-hundred-four patients (72 males and 32 females) with documented stones were included in this study with a mean age of 49.0 years (range 21-78) and a mean stone burden of 5.3 mm (range 1-21 mm). Stones were located in the kidney in 60 (57.7%) patients, the ureter in 30 (28.8%) patients, and multiple locations in 14 (14.5%) patients. The 30 ureteral stones were located at the ureteropelvic junction, proximal ureter, distal ureter, and ureterovesical junction in 2, 6, 14, and 8 patients,
Comment
In the present study, the total number and the average number of IVUs, fluoroscopic studies, plain radiographs, and CT scans significantly decreased during the second year, whereas the total number and the average number of US studies significantly increased during the second year (P <.05) (Table 1). In particular, the average number of CT scans per patient during the first year of follow-up was 0.82 scans. This is lower than the mean of 1.7 CT scans per patient in the study by Ferrandino and
Conclusions
It is important to calculate the effective radiation exposure when DLP values are available for CT scans because there are wide variations in doses among patients. Furthermore, the effective radiation exposure doses caused by CT scans are above previous estimates. Although a significant portion of patients were exposed to MERE doses above the 50 mSv threshold during the first year of follow-up, none exceeded this threshold in the second year because of significantly fewer CT scans and
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Cited by (0)
Funding Support: This work was supported in part by the Northeastern AUA Young Investigator Award and Montreal General Hospital Foundation Award to Sero Andonian.