Low-dose unenhanced CT protocols according to individual body size for evaluating suspected renal colic: cumulative radiation exposures

Tartari, Stefano; Rizzati, Roberto; Righi, Riccardo; Deledda, Alessandro; Terrani, Simone; Benea, Giorgio

doi:10.1007/s11547-009-0476-5

Cited by 21 publications

(5 citation statements)

References 29 publications

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“…Thomas calculate effective dose in abdomen-pelvic examination for adults, by calculating DLP and using the related conversion factor to estimate the effective dose, 5.9mSv was achieved [31]. This study reported a linear relationship between increasing BMI and DLP with proper compliance and effective dose described, which is fully consistent with the results of Tartari [32].…”

Section: Discussionsupporting

confidence: 85%

A New Method for Estimating of Patient Effective Dose in Computed Tomography Based on Body Mass Index: Performance of the Method in Abdomen-Pelvic Examination

Deevband

2018

CTCMI

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Background and Objective: Along with all the benefits that CT-scan has, the dose is much higher than other radiology procedures. The nobility of the present scientific study was to investigate how the introduction of MDCT scanners and patient-size-dependent imaging protocols have affected patient doses.Materials and Methods: Demographic data of each patient were recorded as well as data from a CT scan of the abdomen and pelvic of 52 patients were studied. For assessment of patient and effective doses, the information related to the scan in ImPACT software was applied. The results are analyzed and regression was used in order to examine the relation between the results of the scan data in MATLAB environment. Findings:The research findings showed that the received dose to the most patients is the same as determined by the ICRP103. An average of the effective dose was less than predicted amount by ICRP103. In addition, to estimate the effective dose of the body, according to the patient's BMI, an equation was obtained that the results from this equation are corresponded to the calculated dose by Impact (R2>0.95). In addition, the method was proposed to predict the parameters of mA effand DLP resulted from the related scan. Conclusion:According to the results of this study, authors proposed a good alternative to estimate the effective dose according to BMI instead of ImPACT calculations for scanners and scanning conditions as well as a method to predict the effective dose by using the parameters of the CT system and BMI without being radiated on the patients.

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Section: Discussionsupporting

confidence: 85%

A New Method for Estimating of Patient Effective Dose in Computed Tomography Based on Body Mass Index: Performance of the Method in Abdomen-Pelvic Examination

Deevband

2018

CTCMI

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“…This may be accomplished by not doing a CT or by performeing a “low‐dose” CT scan. While data about low‐dose CT protocols for renal colic have been published in Europe, and the use of low‐dose protocols has been suggested in the United States, to our knowledge no large trial of kidney stones diagnosed in the ED in the United States using low‐dose protocols in actual patients has been published . Data from our institution examining CTs for renal colic between 1996 and 2002 found an effective radiation dose of approximately 6.5 mSv for single‐detector CTs and 8.5 mSv for multidetector CT .…”

Section: Discussionmentioning

confidence: 92%

Prevalence and Clinical Importance of Alternative Causes of Symptoms Using a Renal Colic Computed Tomography Protocol in Patients With Flank or Back Pain and Absence of Pyuria

Moore

Daniels

Singh

et al. 2013

Academic Emergency Medicine

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Objectives: The study was undertaken to determine the prevalence and clinical importance of alternative causes of symptoms discovered in patients undergoing flank pain protocol (FPP) computed tomography (CT) scans in patients with classic symptoms of kidney stone (flank pain, back pain, or both) without evidence of urine infection.Methods: This was a retrospective observational analysis of all adult patients undergoing FPP CT scans at two emergency departments (EDs) between April 2005 and November 2010. All CTs (N = 5,383) were reviewed and categorized as "no cause of symptoms seen on CT," "ureteral stone as cause of symptoms," or "non-kidney stone cause of symptoms." Non-kidney stone scans were further categorized as "acutely important," "follow-up recommended," or "unimportant cause," based on a priori diagnostic classifications. All nonstone causes of pain and a random subset of subjects (n = 1,843; 34%) underwent full record review blinded to CT categorization to determine demographics, whether flank and/or back pain was present, and whether there was objective evidence of pyuria.Results: Of all FPP CT scans during the study period, a ureteral stone was found to cause symptoms in 47.7% of CTs, with no cause of symptoms found in 43.3% of CTs. A non-kidney stone diagnosis was found in 9.0% of all CTs, with 6.1% being categorized as "acutely important," 2.2% as "follow-up recommended," and 0.65% with symptoms from an "unimportant cause." In the randomly selected subset undergoing full record review, categorizations were similar, with 49.0% of CTs showing kidney stone as cause of pain and 9.0% a non-kidney stone cause (5.9% "acutely important"). When subjects with evidence of urine infection or without flank or back pain were excluded, ureteral stone was identified as the cause of pain in 54.9% of CTs, while non-kidney stone cause of symptoms was found in 5.4% of scans and acutely important alternate causes in 2.8% of scans.Conclusions: While a non-kidney stone cause for a patient's symptoms are found in nearly 10% of CTs done using a FPP, acutely important findings occur in less than 3% of scans done in patients with flank or back pain and absence of pyuria.ACADEMIC EMERGENCY MEDICINE 2013; 20:470-478 © 2013 by the Society for Academic Emergency Medicine C omputed tomography (CT) has been described as the "best imaging study to confirm the diagnosis of urinary stone," a condition that will occur in up to 12% of the population and recur in as many as 50% of these patients. 1 CT is now the first-line imaging test for suspected kidney stone, and use of CT in the emergency department (ED) has increased over 300% from 1996 to 2007, with ED patients who present with complaints of abdominal pain and flank pain seeing the highest growth in use of CT as part of their evaluation. 2,3 While CT scans are recognized as an accurate diagnostic test for kidney stone and for identifying alternative causes of symptoms, the benefit of this accuracy needs to be balanced against the risk of the test, specifically future ma...

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“…Utilization of point‐of‐care ultrasound (POCUS) can be used in acute settings to rapidly rule in the diagnosis of renal colic and to avoid nonselective, standard‐dose CT scan examination for all renal colic patients . It has been suggested that ultrasound‐first approach can avoid radiation exposure in about 70% of cases .…”

mentioning

confidence: 99%

Emergency Physician Interpretation of Point‐of‐care Ultrasound for Identifying and Grading of Hydronephrosis in Renal Colic Compared With Consensus Interpretation by Emergency Radiologists

Pathan

Mitra

Mirza

et al. 2018

Academic Emergency Medicine

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Low-dose unenhanced CT protocols according to individual body size for evaluating suspected renal colic: cumulative radiation exposures

Cited by 21 publications

References 29 publications

A New Method for Estimating of Patient Effective Dose in Computed Tomography Based on Body Mass Index: Performance of the Method in Abdomen-Pelvic Examination

A New Method for Estimating of Patient Effective Dose in Computed Tomography Based on Body Mass Index: Performance of the Method in Abdomen-Pelvic Examination

Prevalence and Clinical Importance of Alternative Causes of Symptoms Using a Renal Colic Computed Tomography Protocol in Patients With Flank or Back Pain and Absence of Pyuria

Emergency Physician Interpretation of Point‐of‐care Ultrasound for Identifying and Grading of Hydronephrosis in Renal Colic Compared With Consensus Interpretation by Emergency Radiologists

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