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Assessment Of Radiation Exposure From Diagnostic Imaging In Patients Undergoing Ureteroscopy With Laser Lithotripsy For Upper Tract Stones
Brooke A Harnisch, Jessica E Kreshover, Aylin Bilgutay, Richard K Babayan, David S Wang
Boston University and Boston Medical Center, Boston, MA

Introduction:
Patients with urolithiasis who undergo ureteroscopy (URS) are commonly diagnosed with CT, X-ray, and renal ultrasound. There has been recent concern that these patients are at increased risk for radiation exposure above the annual limit of 50 millisieverts (mSv) due to diagnostic imaging, especially with CT scan. Therefore, we evaluated the number of imaging studies and the amount of radiation exposure to patients undergoing URS for upper tract stones.
Methods:
An IRB approved retrospective study was conducted on patients who underwent URS between 2003-2007. Total number of imaging studies was analyzed over 1-14 months. Time period of data collection was determined from the initial diagnosis of the stone until 6 weeks following completion of URS. Radiation dose was calculated using effective radiation dose standards.
Results:
286 patients were identified. Mean size of stone was 8.71 +/- 4.2 mm. The most common stone location was renal (43%). Patients underwent an average of 1.6 CT scans (range 0 to 6) over an average of 5 months. 124 patients (43%) received > 50mSv which is equivalent to a > 2 CT scans. Smaller stone size and stone location increased the probability of receiving > 2 CT scans in one year (p=0.02). Patient age, stent placement, and/or post surgical complications were not significant.
Conclusions:
43% received > 50mSv of radiation over one year. Smaller size and mid/distal location of the stone significantly increased the risk of receiving a higher number of imaging studies emphasizing the increased radiation risk to patients with urolithiasis.


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