Salisbury District Hospital, Salisbury, UK.
Urologia. 2021 Nov;88(4):362-368. doi: 10.1177/0391560321994443. Epub 2021 Feb 13.
Urolithiasis patients often require frequent urinary tract imaging, leading to high radiation exposure. CT Kidney-Ureter-Bladder (CT-KUB) is the gold standard in urolithiasis detection, however it is thought to harbour significant radiation load. Urologists have therefore utilised abdominal radiographs (XR-KUB) as an alternative, though with markedly lower sensitivity and specificity. We present the first contemporary UK study comparing the effective doses of XR-KUBs with low dose CT-KUBs.
Fifty-three patients were retrospectively identified in a single centre 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 formula.
The average effective dose of XR-KUBs and low dose CT-KUBs were 5.10 mSv and 5.31 mSv respectively. Thirty-four percent (18/53) of patients had a XR-KUBs with a higher effective dose than their low dose CT-KUB. Patients with higher Weight, BMI and AP diameter had higher effective doses for both their XR and low dose CT-KUBs. All patients in our study weighing over 92 kg or with a BMI greater than 32 had a XR-KUBs with a higher effective dose than their low dose CT-KUB.
This data supports moving away from XR-KUBs for the investigation of urolithiasis, particularly in patients with a high BMI.
尿石症患者通常需要频繁进行尿路影像学检查，导致辐射暴露量较高。CT 肾-输尿管-膀胱（CT-KUB）是诊断尿石症的金标准，但它被认为具有较大的辐射负荷。因此，泌尿科医生已将腹部 X 射线（XR-KUB）作为替代方法，但敏感性和特异性明显较低。我们报告了第一份比较 XR-KUB 和低剂量 CT-KUB 有效剂量的英国当代研究。
在一家单中心回顾性确定了 53 例 2018 年同时接受 XR-KUB 和 CT-KUB 的患者。通过国际辐射防护委员会公式将记录的“剂量面积/长度乘积”转换来测量有效剂量。
XR-KUB 和低剂量 CT-KUB 的平均有效剂量分别为 5.10 mSv 和 5.31 mSv。34%（18/53）的患者的 XR-KUB 有效剂量高于其低剂量 CT-KUB。体重、BMI 和 AP 直径较高的患者，其 XR 和低剂量 CT-KUB 的有效剂量均较高。我们研究中的所有体重超过 92kg 或 BMI 大于 32 的患者，其 XR-KUB 的有效剂量均高于其低剂量 CT-KUB。
该数据支持放弃 XR-KUB 用于尿石症的检查，特别是在 BMI 较高的患者中。
