Comprehensive approach to kidney stone CT radiation dose reduction in an Emergency Department.

Congress:

EuroSafe Imaging 2020

Poster Number:

ESI-05073

Type:

EuroSafe Imaging

Keywords:

Performed at one institution, Not applicable, Calcifications / Calculi, Technical aspects, CT, Radioprotection / Radiation dose, Kidney, Emergency, Physics in Medical Imaging

Authors:

S. Y. Andrabi, C. Martel, J. broder, C. Wald

DOI:

10.26044/esi2020/ESI-05073

DOI-Link:

https://dx.doi.org/10.26044/esi2020/ESI-05073

Fig. 1: Study design. Chart in right hand corner comparing KS-CT radiation dose in...

Fig. 2: Summarization of Comprehensive approach to radiation dose reduction.

Fig. 3: Table and chart comparing scan protocols and radiation doses between Group A...

Fig. 4: Chart 1, comparing radiation doses with National and institutional averages....

Background/introduction

Computer tomography (CT) has emerged as an imaging modality of choice for initial evaluation and follow-up of patients with suspected kidney stones. (1,2) Radiation doses from CT examination remains a concern, especially in young, otherwise healthy patients and those who need multiple follow-up CT exams resulting in high cumulative radiation doses. (3,4) Efforts have been made to lower radiation doses associated with kidney stone CT (KS-CT) examinations by using low dose CT scan protocols. With integration of new generation CT scanners and Advanced Iterative Reconstruction...

Description of activity and work performed

This study was an Institutional Review Board approved, consent-waived retrospective data analysis of kidney stone CT exams (KS-CT) performed in our Institution from March 2017 through March 2018 (1 year period). Two 3rdgeneration128and 256 slice CT scanners (Philips; Ingenuity 128 and iCT 256, respectively) were installed in our emergency-department (ED) from March 2017. Dedicated KS-CT protocols utilized on non-ED scanners in our department were adapted to ED-CT scanners (mAS=180, DRI=19, kV=100-120). Images were reconstructed using Model Based Iterative Reconstruction (MBIR) algorithm. Doses were monitored using...

Conclusion and recommendations

The benefits of New generation CT scanners equipped with iterative reconstruction algorithms has been well reported, especially with newer generation algoriths (MBIR) demonstrating further dose reduction benefits(14). Despite the integration of 3rd generation CT technology and advanced IR algorithms in our practice, radiation dose in Group A were higher than institutional and National averages for KS-CT exams Although technological advances are imperative for dose reduction, however, consideration of other contributing factors are essential to achieve intended dose reduction benefits. After installation/ upgradation of new technology,...

Personal/organisational information

S. Y. Andrabi; Burlington/US - nothing to disclose C. Wald; Nahant, MA/US - Advisory Board at Philips healthcare (occasional clinical advisor) J. Broder; Burlington/US - nothing to disclose C. Martel; Burlington/US - Employee at Philips Healthcare

References

Gottlieb RH, La TC, Erturk EN, Sotack JL, Voci SL, Holloway RG, et al. CT in detecting urinary tract calculi: influence on patient imaging and clinical outcomes. Radiology. 2002;225(2):441-9. Andrabi, Y., Patino, M., Das, CJ., et.al. Advances in CT imaging for urolithiasis. Indian journal of urology. 2015 Jul; 31:185 Cullen IM, Cafferty F, Oon SF, Manecksha R, Shields D, Grainger R, et al. Evaluation of suspected renal colic with noncontrast CT in the emergency department: a single institution study. J Endourol. 2008;22(11):2441-5 Fahmy NM, Elkoushy...