Journal article
CT protocols and radiation doses for hematuria and urinary stones: Comparing practices in 20 countries
European journal of radiology, Vol.126, pp.108923-108923
05/2020
DOI: 10.1016/j.ejrad.2020.108923
PMID: 32171911
Abstract
•Few surveyed hospitals used low radiation doses for urinary stone protocol CT.•CT urography and routine abdomen-pelvis CT were associated with high doses.•Inappropriate multiphase scanning caused substantial variations in radiation doses.
Patients with hematuria and renal colic often undergo CT scanning. The purpose of our study was to assess variations in CT protocols and radiation doses for evaluation of hematuria and urinary stones in 20 countries.
The International Atomic Energy Agency (IAEA) surveyed practices in 51 hospitals from 20 countries in the European region according to the IAEA Technical cooperation classification and obtained following information for three CT protocols (urography, urinary stones, and routine abdomen-pelvis CT) for 1276 patients: patient information (weight, clinical indication), scanner information (scan vendor, scanner name, number of detector rows), scan parameters (such as number of phases, scan start and end locations, mA, kV), and radiation dose descriptors (CTDIvol, DLP). Two radiologists assessed the appropriateness of clinical indications and number of scan phases using the ESR Referral Guidelines and ACR Appropriateness Criteria. Descriptive statistics and Student’s t tests were performed.
Most institutions use 3–6 phase CT urography protocols (80 %, median DLP 1793−3618 mGy.cm) which were associated with 2.4–4.9-fold higher dose compared to 2-phase protocol (20 %, 740 mGy.cm) (p < 0.0001). Likewise, 52 % patients underwent 3–5 phase routine abdomen- pelvis CT (1574−2945 mGy.cm) as opposed to 37 % scanned with a single-phase routine CT (676 mGy.cm). The median DLP for urinary stones CT (516 mGy.cm) were significantly lower than the median DLP for the other two CT protocols (p < 0.0001).
Few institutions (4/13) use low dose CT for urinary stones. There are substantial variations in CT urography and routine abdomen-pelvis CT protocols result in massive radiation doses (up to 2945−3618 mGy.cm).
Details
- Title: Subtitle
- CT protocols and radiation doses for hematuria and urinary stones: Comparing practices in 20 countries
- Creators
- Vesna Gershan - Saints Cyril and Methodius University of SkopjeFatemeh Homayounieh - Massachusetts General HospitalRamandeep Singh - Massachusetts General HospitalSimona Avramova-Cholakova - Imperial College Healthcare NHS TrustDario Faj - University of OsijekEmil Georgiev - Tokuda HospitalOlga Girjoaba - National Institute of Public Health, Bucharest, RomaniaBirute Griciene - Vilnius UniversityEdward Gruppetta - Mater Dei HospitalDarka Hadnadjev Šimonji - Clinical Center Vojvodina, Center for Radiology, Novi Sad, SerbiaSiarhei Kharuzhyk - N.N. Alexandrov National Cancer CentreAndrej Klepanec - University of TrnavaDesisslava Kostova-Lefterova - National Heart HospitalAnna Kulikova - National Center of Cardiology and Internal MedicineIvan Lasic - University Clinical Hospital MostarAleksandra Milatovic - University of MontenegroGraciano Paulo - Escola Superior de Tecnologia da Saúde de CoimbraJenia Vassileva - International Atomic Energy AgencyMannudeep K. Kalra - Massachusetts General Hospital
- Resource Type
- Journal article
- Publication Details
- European journal of radiology, Vol.126, pp.108923-108923
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.ejrad.2020.108923
- PMID
- 32171911
- ISSN
- 0720-048X
- eISSN
- 1872-7727
- Language
- English
- Date published
- 05/2020
- Academic Unit
- Radiology
- Record Identifier
- 9984697623302771
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