Purpose or learning objective
Computed tomography of the kidneys, ureters and bladder (CT KUB) is a commonly performed procedure in emergency departments, as it is the first-line test in suspected renal colic (1). However, as imaging techniques involving ionising radiation become more common, it is important that these tests are used appropriately; the area of the body scanned should be limited to what is needed to answer the clinical question (2).This is particularly important as CT KUB scans are performed in a relatively young cohort of patients.
Therefore the...
Methods or background
We retrospectively reviewed 50 CT KUB scans done at Rotherham NHS Foundation trust from the period of 19/6/2020 to 13/9/2020 taken randomly from different days.
The below data were collected from each scan:
a) Hospital number
b) Date of scan
c) Total number of slices
d)Sex of the patient
e) Location of request (department).
f) Slices above upper pole of highest kidney (overscan slices).
g) Percentage of total scan that is “overscan” i.e. e/d x 100
Results or findings
Results:
100% of the CT KUB scans performed for had >10%excess scan length.
34% (17 out of 50) ofthepercentage ofoverscan slices were between10-20%
56% (28 out of 50) of the percentage ofoverscan slices were between 20-30%
10% (5 out of 50) of the percentage ofoverscan slices were more than 30%.
Conclusion
Results showed that that 100% of the scan exceeds appropriate scane lenght. The department needs to obtain a local departmental policy regarding CT KUB scan. Audit was presented in our department. Radiographers were taught regarding the matter. It was suggested to obtain T12 as a landmark to start CT KUB scan from(3). Radiographers were re-educated about the scan length highlighting importance of limiting the scan area as implementing such changes are essential to maintain safety in every scan done.
References
References:
1-British Association of Urological Surgeons (BAUS); Guidelines for acute management of first presentation of renal and uretericlithiasis,2012.http://www.baus.org.uk/_userfiles/pages/files/Publications/RevisedAcuteStoneMgtGuidelines.pdf (last accessed 31/08/2015).
2- IAEA Radiation Protection of Patients, Information for HealthProfessionals;rpop.iaea.org/RPOP/RPoP/Content/InformationFor/HealthProfessionals/6_OtherClinicalSpecialities/Urology/(last accessed 31/08/2015).
3- Fundamentals of Body CT. Third Edition. Webb WR, Brant WE, Major NM. Elsevier- Health siences division. Novomber 2005. Page 276`
Personal information and conflict of interest
A. Elkady:
Nothing to disclose
M. Ibrahim:
Nothing to disclose
M. Osman:
Nothing to disclose
