Are we over-radiating our patients? An audit of CT KUB scan length
Author(s):
Dr Nick Simson
,
Dr Nick Simson
Affiliations:
Dr Thomas Stonier
,
Dr Thomas Stonier
Affiliations:
Dr Harpreet Kaur Sekhon Inderjit Singh
,
Dr Harpreet Kaur Sekhon Inderjit Singh
Affiliations:
Mr Alberto Coscione
,
Mr Alberto Coscione
Affiliations:
Mr Ahmed Qteishat
Mr Ahmed Qteishat
Affiliations:
BAUS ePoster online library. Stonier T. 06/26/17; 177354; P2-8
Mr. Thomas Stonier
Mr. Thomas Stonier
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Abstract
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Introduction: CTKUB is the first line investigation in suspected renal colic. Given the cumulative risk of ionising radiation, we have a responsibility to limit the dose of radiation we give to our patients.

There exist 2 recommendations from the Royal College of Radiologists regarding CTKUB scan length.

1) Excess scan length above the upper pole of the highest kidney should not exceed 10% of total length of scan. (So called '10% overscan')
2) Accepted practice is to image from the superior border of the kidneys (T10-T12) to the symphysis pubis.
We aim to audit our current practice against these guidelines

Methods:
Retrospective analysis of 100 patients undergoing CTKUB for suspected renal colic between 1st November and 1st December 2016.

Results:

1) 19% of scans were compliant by having less than 10% overscan. 68% of scans had between 10-20% overscan, and 13% had >20% overscan.
2) 46% of scans had their superior border at the level of T9 or above. 42% of scans had their inferior border below the level of the lesser trochanter of femur. 67% of scans started either too cranially or finished too caudally.

There were no incidental findings above the level of the kidney or below the pubic symphysis in any of the scans. (0%)

Discussion:
With no clear guidelines in place for CTKUB, we are over-radiating between 67-81% of our patients unnecessarily with no diagnostic benefit. By incorporating a clear guideline as above, we aim to reduce the radiation we expose our patients to.
Introduction: CTKUB is the first line investigation in suspected renal colic. Given the cumulative risk of ionising radiation, we have a responsibility to limit the dose of radiation we give to our patients.

There exist 2 recommendations from the Royal College of Radiologists regarding CTKUB scan length.

1) Excess scan length above the upper pole of the highest kidney should not exceed 10% of total length of scan. (So called '10% overscan')
2) Accepted practice is to image from the superior border of the kidneys (T10-T12) to the symphysis pubis.
We aim to audit our current practice against these guidelines

Methods:
Retrospective analysis of 100 patients undergoing CTKUB for suspected renal colic between 1st November and 1st December 2016.

Results:

1) 19% of scans were compliant by having less than 10% overscan. 68% of scans had between 10-20% overscan, and 13% had >20% overscan.
2) 46% of scans had their superior border at the level of T9 or above. 42% of scans had their inferior border below the level of the lesser trochanter of femur. 67% of scans started either too cranially or finished too caudally.

There were no incidental findings above the level of the kidney or below the pubic symphysis in any of the scans. (0%)

Discussion:
With no clear guidelines in place for CTKUB, we are over-radiating between 67-81% of our patients unnecessarily with no diagnostic benefit. By incorporating a clear guideline as above, we aim to reduce the radiation we expose our patients to.
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