The impact of new methods of imaging on radiation dosage delivered to patients.

PURPOSE OF REVIEW

Ionizing radiation is produced by many of the imaging studies used in the diagnosis, management, and follow-up of patients with urolithiasis. Knowing the small, but significant, risks of solid and hematological malignancies associated with increased radiation exposure, our purpose is to discuss new imaging modalities that limit radiation exposure without compromising the valuable information needed by clinicians for appropriate management.

RECENT FINDINGS

Recent studies suggest that many patients with urolithiasis may be subjected to relatively high doses of ionizing radiation during acute stone episodes and throughout the management of their disease, due, in large part, to the rapidly increasing usage of computed tomography (CT). Certain imaging modalities, most notably low-dose CT, have shown promise in reducing radiation dose to patients while maintaining comparable sensitivity and specificity to standard CT, under most conditions.

SUMMARY

Urologists who use radiographic imaging in the care of their patients, must be aware of the risks of ionizing radiation. Accordingly, every effort must be made to limit radiation exposure, especially in the most susceptible populations. In our view, low-dose CT is currently the best imaging modality for patients with urolithiasis, as it offers adequate image quality with much reduced radiation exposure.