Objective: To compare the effective doses (ED) associated with imaging modalities for follow-up of patients with urolithiasis, including stone protocol NCCT, KUB, IVP and digital tomosynthesis (DT).
Methods: A validated Monte Carlo simulation-based software PCXMC 2.0 (STUK, Finland) designed for estimation of patient dose from medical x-ray exposures was used to determine the ED for KUB, IVP (KUB scout plus 3 tomographic images) and DT (2 scouts and 1 tomographic sweep). Simulations were performed using a 2D stationary field onto the corresponding body area of the built-in digital phantom, with actual kVp, mAs, and geometrical parameters of the protocols. The ED for NCCT was determined using an anthropomorphic male phantom which was placed prone on a 64-slice GE Healthcare VCT scanner. High sensitivity metal oxide semiconductor field effect transistors (MOSFET) dosimeters were placed at 20 organ locations and used to measure organ radiation doses.
Results: The ED for a stone protocol NCCT was 3.04±0.34 mSv. The ED for a KUB was 0.63 mSv and 1.1 mSv for the additional tomographic film. The total ED for IVP was 3.93 mSv. The ED for digital tomosynthesis performed with two scouts and one sweep (60.0°) was 0.83 mSv.
Conclusions: Among the different imaging modalities for follow-up of patients with urolithiasis, DT was associated with the least radiation exposure (0.83 mSv). This effective dose corresponds to a fifth of NCCT or IVP studies. Further studies are needed to demonstrate the sensitivity and specificity of DT for the follow-up of nephrolithiasis patients.
Written by:
Astroza G, Neisius A, Wang AJ, Nguyen G, Toncheva G, Wang C, Januzis N, Lowry C, Ferrandino MN, Neville AM, Yoshizumi TT, Preminger GM, Lipkin ME. Are you the author?
Duke University Medical Center, Division of Urologic Surgery, Durham, North Carolina, United States; Pontificia Universidad Católica de Chile, Urology, Marcoleta 367, Santiago, Santiago, Chile, 8330024;
Reference: J Endourol. 2013 Jun 4. Epub ahead of print.
doi: 10.1089/end.2013.0255
PubMed Abstract
PMID: 23734577
UroToday.com Stone Disease Section
