Do CT KUBs really expose patients to more radiation than plain abdominal radiographs?
BAUS ePoster online library. Yang B. Jun 24, 2019; 259464; P1-5
Mr. Bob Yang
Mr. Bob Yang
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Abstract
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INTRODUCTION:

Urolithiasis patients often require repeated and frequent urinary tract imaging, leading to high radiation exposure. CT Kidney-Ureter-Bladder (CT-KUB) is the gold standard in urolithiasis detection, however is commonly thought to harbour significant radiation load. Urologists have therefore utilised abdominal radiographs of the kidney-ureter-bladder (XR-KUB) as an alternative, though with significantly lower sensitivity and specificity.

Historical guidelines state the Effective-Dose of XR-KUBs at 0.8mSv. However no UK data exists comparing the contemporary radiation Effective-Dose between XR-KUBs and CT-KUBs.

We compared the radiation Effective-Dose (mSv) in patients who has recently had both an XR-KUB and CT-KUB.

METHODS:

53 patients were retrospectively identified who underwent both a XR-KUB and a CT-KUB in 2018. Effective-Dose was measured by converting the recorded 'Dose Area/Length Product' via the International Commission on Radiological Protection report 103 formulation.

Results:

The average Effective-Dose for XR-KUBs was 5.10mSv [Range: 0.8 - 42.4]. The average Effective-Dose for CT-KUBs was 5.31mSv [Range: 1.4 – 30.5].
18/53 (34%) of patients underwent XR-KUBs with higher radiation Effective-Dose levels than their following CT-KUB.
Patients with higher BMIs received greater doses for both XR-KUB and CT-KUB.

Conclusion:

The Effective-Dose of XR-KUB was on average 5-fold higher than historically referenced. Furthermore, for 1-in-3 patients, the radiation Effective-Dose of CT-KUBs was less than that of the preceding XR-KUB.

Given the higher than expected radiation dose associated with XR-KUBs and its' limited sensitivity/specificity, other imaging modality such as Ultrasound-KUB and CT-KUB should be considered.
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