1 Division of Urologic Surgery, Duke University Medical Center , Durham, North Carolina.
J Endourol. 2013 Oct;27(10):1187-91. doi: 10.1089/end.2013.0255. Epub 2013 Aug 20.
To compare the effective doses (EDs) associated with imaging modalities for follow-up of patients with urolithiasis, including stone protocol non-contrast computed tomography (NCCT), kidney, ureter, and bladder radiograph (KUB), intravenous urogram (IVU), and digital tomosynthesis (DT).
A validated Monte-Carlo simulation-based software PCXMC 2.0 (STUK) designed for estimation of patient dose from medical X-ray exposures was used to determine the ED for KUB, IVU (KUB scout plus three tomographic images), and DT (two scouts and one tomographic sweep). Simulations were performed using a two-dimensional stationary field onto the corresponding body area of the built-in digital phantom, with actual kVp, mAs, and geometrical parameters of the protocols. The ED for NCCT was determined using an anthropomorphic male phantom that was placed prone on a 64-slice GE Healthcare volume computed tomography (VCT) scanner. High-sensitivity metal oxide semiconductor field effect transistors dosimeters were placed at 20 organ locations and used to measure organ radiation doses.
The ED for a stone protocol NCCT was 3.04±0.34 mSv. The ED for a KUB was 0.63 and 1.1 mSv for the additional tomographic film. The total ED for IVU was 3.93 mSv. The ED for DT performed with two scouts and one sweep (14.2°) was 0.83 mSv.
Among the different imaging modalities for follow-up of patients with urolithiasis, DT was associated with the least radiation exposure (0.83 mSv). This ED corresponds to a fifth of NCCT or IVU studies. Further studies are needed to demonstrate the sensitivity and specificity of DT for the follow-up of nephrolithiasis patients.
比较随访尿路结石患者的各种影像学方法的有效剂量（ED），包括结石方案非对比 CT（NCCT）、肾脏-输尿管-膀胱 X 线摄影（KUB）、静脉尿路造影（IVU）和数字断层合成（DT）。
使用基于验证的蒙特卡罗模拟软件 PCXMC 2.0（STUK）来确定 KUB、IVU（KUB 平片加三个断层图像）和 DT（两个平片和一个断层扫描）的 ED。使用二维固定场对内置数字体模的相应身体区域进行模拟，使用实际的千伏值、毫安秒和协议的几何参数。通过将一个俯卧位的男性体模放置在通用电气医疗系统的 64 层容积 CT（VCT）扫描仪上，来确定 NCCT 的 ED。高灵敏度金属氧化物半导体场效应晶体管剂量计放置在 20 个器官位置，用于测量器官辐射剂量。
结石方案 NCCT 的 ED 为 3.04±0.34 mSv。KUB 的 ED 为 0.63 mSv，额外的断层片为 1.1 mSv。IVU 的总 ED 为 3.93 mSv。使用两个平片和一个 14.2°扫描的 DT 的 ED 为 0.83 mSv。
在随访尿路结石患者的各种影像学方法中，DT 放射暴露量最少（0.83 mSv）。这个 ED 相当于 NCCT 或 IVU 研究的五分之一。需要进一步的研究来证明 DT 在随访肾结石患者中的敏感性和特异性。
