In patients with acute flank pain computed tomography of the kidney, ureter, bladder (CT KUB) is the favoured imaging technique to confirm the diagnosis of urinary tract calculi in patients with acute flank pain in accordance with the Royal College of Radiologists and British Association of Urological Surgeons guidelines1,2. Dose rates are reduced by decreasing the size of the scan field with many authors quoting the upper border of T12 as an appropriate landmark to commence the examination3. Furthermore, restricting the scanned area reduces the...

Standard: Local departmental policy states that the acquisition area for CT KUB should be from the superior border of the kidneys to the symphysis pubis.4 Indicator: Vertebral level at which CT KUB scan commenced. Target: 100% of CT KUB scans should commence at T10–T12 or within two vertebral body levels above the superior border of the kidney if above T12. Methodology: Retrospective review of 100 consecutive CT KUB examinations from 17/3/14–30/4/14 performed at Hairmyres hospital. All data accessed from local radiology information system (RIS). Data...

The changes implemeted have resulted in improved adherence with CT KUB scanning protocol, a reduction in patient dose and decrease in image storage requirements.

Dr. John Maguire, Registrar Radiologist. Dr. Karen Gray, Consultant Radiologist. Hairmyres Hospital, NHS Lanarkshire, UK.

1. Making best use of a Department of Clinical Radiology, Guidelines for Doctors, Sixth Edition 2007, The Royal College of Radiologists. London. 2. British Association of Urological Surgeons (BAUS) guidelines for acute management of first presentation of renal/ureteric lithiasis, December 2008. 3. Webb WR, Brant WE, Major NM. Fundamentals of body CT. Third edition. Oxford: Elsevier - Health Sciences Division, 2005. 4. Level 3 Standard Operating Procedure. CT Scanning. Hairmyres Hospital. December 2009.