2. UroToday Home
  3. Recent Abstracts
  4. Endourology & Urolithiasis
  5. Minimally Invasive Procedures

EAU 2018: What Doses are our Patients Receiving? The Radiation Dose Associated with CT, RIRS and PCNL

Copenhagen, Denmark (UroToday.com) Natural background radiation in the United Kingdom has been estimated to be approximately 2.2mSv. As reference, the health risks of cancer from diagnostic x-rays have been estimated to cause 700 cancers / year. Additionally, the cancer risk associated with these diagnostic scans has been estimated to be 1 in 15,000 per mSv and 1 in 2000 per 10mSv. In standard practice, patients with stone disease [and, in particular, those undergoing percutaneous nephrolithotomy (PCNL)] are referred to these standard values when undergoing CT scans. However, it remains unclear whether these doses are accurate with current instrumentation and center-specific practices.

Dr. Lobo of Guy’s and St Thomas’ NHS Foundation Trust Department of Urology in London, United Kingdom presented a retrospective analysis of radiation doses received by patients undergoing stone procedures at their institution. More specifically, CT KUBs (n=669) and CT IVUs (n=70) were reviewed from September 2014 to April 2015 and November 2015 and December 2015, respectively. Further, patients undergoing ureteroscopy (n=67) and PCNL (n=24) were also reviewed.

Of the 669 patients undergoing CT KUB and 70 patients undergoing CT IVU, the median dose length product (DLP) was 2.3 mSv [national reference: 6mSv] and 8.3mSv [national reference: 14mSv]. Patients undergoing URS had a median DLP of 0.2 mSv [literature reference: 0.67-2.3 mSv], while patients undergoing PCNL had a median DLP of 1.9 mSv [literature reference: 0.56-4.5 mSv].

In discussion, Dr. Lobo notes that a significant limitation of the current study was the low mean BMI for PCNL patients (27 kg/m2), with only four patients with BMI over 30 kg/m2. Larger series with a more diverse patient population and  multivariable analysis  are required to assess effective DLP for URS and PCNL. However, considering that the suggested average lifetime risk for cancer increases by 3% for every 10mSv, rigorous studies assessing effective dosages such as the current study are a necessary, periodic practice.


Presented by: Lobo N., MD, Guy's and St Thomas' NHS Foundation Trust, Dept. of Urology, London, United Kingdom

Co-Authors: Patel P,1 Honey I.2, Gallagher D.2, Rottenberg G.3, Glass J.1, Thomas K.1, Bultitude M.1
Author Information: 
1. Guy's and St Thomas' NHS Foundation Trust, Dept. of Urology, London, United Kingdom
2. Guy's and St Thomas' NHS Foundation Trust, Dept. of Medical Physics, London, United Kingdom
3. Guy's and St Thomas' NHS Foundation Trust, Dept. of Radiology, London, United Kingdom

Written by: Linda M. Huynh, BS, Department of Urology, University of California-Irvine at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark