Assessment of the efficacy of reduced-radiation noncontrast computed tomography scan compared with the standard noncontrast computed tomography scan for detecting urolithiasis : A prospective single-center study
Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc..
Background: Noncontrast computed tomography (CT) scan of the kidneys, ureter and bladder is the standard investigative modality for diagnosing and following up patients with urolithiasis. With each scan, a patient receives radiation of 18-34 mGy. Dose considerations become pertinent because of a 10% lifetime incidence rate and higher than 50% risk of recurrence, necessitating repeated imaging in the lifetime of a stone former. Hence, this study aimed to assess the sensitivity of "reduced-radiation" CT imaging by altering scan settings to lower than the "standard" norms.
Materials and methods: Altogether, 222 patients (255 "kidney-ureter" stone-bearing units or "renal units") with urolithiasis and patients undergoing CT for other reasons with incidental findings of renal/ureteric calculi between 2017 and 2019 were included. All patients were subjected to 3 sequential scans at tube current settings of 250 mA (CT-N/Standard), 100 mA (CT-100), and 50 mA (CT-50) at a constant voltage of 120 kV. Their clinicodemographic and radiological findings were recorded and assessed for significance.
Results: Of the 255 renal units, 117 were between 30 and 44 years of age, 75% were men. Of the 255 patients, 178 (70.1%) reported a first stone episode and 77 had recurrence. Lower ureteric calculi were predominant (40.4%). All calculi were identified on CT-N; CT-100 failed to detect calculi in 1 patient, and CT-50 failed in 3 patients, where all calculi were <3 mm in size. Meanwhile, none were undetected among patients with obesity. The sensitivity was 99.61% for the CT-100 and 98.82% for the CT-50, which indicated a 2.5 and 5 times lower radiation and dose/length, respectively, than CT-N.
Conclusions: The reduced-radiation CT scan is safe, sensitive, and accurate for the diagnosis and follow-up of patients with urolithiasis with significantly lower radiation exposures. Our study lays the foundation to accept low-dose CT in general and CT-50 in particular, as the new "standard of care," and attempt further dose reduction without loss of diagnostic efficacy.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
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| Enthalten in: |
Current urology - 17(2023), 1 vom: 01. März, Seite 18-24 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Aggarwal, Gaurav [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Revised 13.09.2023 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1097/CU9.0000000000000162 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361896093 |
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| 100 | 1 | |a Aggarwal, Gaurav |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Assessment of the efficacy of reduced-radiation noncontrast computed tomography scan compared with the standard noncontrast computed tomography scan for detecting urolithiasis |b A prospective single-center study |
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| 500 | |a Date Revised 13.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. | ||
| 520 | |a Background: Noncontrast computed tomography (CT) scan of the kidneys, ureter and bladder is the standard investigative modality for diagnosing and following up patients with urolithiasis. With each scan, a patient receives radiation of 18-34 mGy. Dose considerations become pertinent because of a 10% lifetime incidence rate and higher than 50% risk of recurrence, necessitating repeated imaging in the lifetime of a stone former. Hence, this study aimed to assess the sensitivity of "reduced-radiation" CT imaging by altering scan settings to lower than the "standard" norms | ||
| 520 | |a Materials and methods: Altogether, 222 patients (255 "kidney-ureter" stone-bearing units or "renal units") with urolithiasis and patients undergoing CT for other reasons with incidental findings of renal/ureteric calculi between 2017 and 2019 were included. All patients were subjected to 3 sequential scans at tube current settings of 250 mA (CT-N/Standard), 100 mA (CT-100), and 50 mA (CT-50) at a constant voltage of 120 kV. Their clinicodemographic and radiological findings were recorded and assessed for significance | ||
| 520 | |a Results: Of the 255 renal units, 117 were between 30 and 44 years of age, 75% were men. Of the 255 patients, 178 (70.1%) reported a first stone episode and 77 had recurrence. Lower ureteric calculi were predominant (40.4%). All calculi were identified on CT-N; CT-100 failed to detect calculi in 1 patient, and CT-50 failed in 3 patients, where all calculi were <3 mm in size. Meanwhile, none were undetected among patients with obesity. The sensitivity was 99.61% for the CT-100 and 98.82% for the CT-50, which indicated a 2.5 and 5 times lower radiation and dose/length, respectively, than CT-N | ||
| 520 | |a Conclusions: The reduced-radiation CT scan is safe, sensitive, and accurate for the diagnosis and follow-up of patients with urolithiasis with significantly lower radiation exposures. Our study lays the foundation to accept low-dose CT in general and CT-50 in particular, as the new "standard of care," and attempt further dose reduction without loss of diagnostic efficacy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Low-dose computed tomography scan | |
| 650 | 4 | |a Reduced-radiation computed tomography scan | |
| 650 | 4 | |a Reduced-radiation imaging | |
| 650 | 4 | |a Ureteric colic | |
| 650 | 4 | |a Urolithiasis | |
| 700 | 1 | |a Adhikary, Samiran Das |e verfasserin |4 aut | |
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| 773 | 1 | 8 | |g volume:17 |g year:2023 |g number:1 |g day:01 |g month:03 |g pages:18-24 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/CU9.0000000000000162 |3 Volltext |
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