Radiation dosage in the urolithiasis population: Do we over-radiate our patients?

Abstract

Introduction:

There is increasing concern about the amount of radiation that patients with urolithiasis receive. Ensuring patients are exposed to the minimum necessary radiation is imperative. Here we review the radiation dosages that newly diagnosed urolithiasis patients received in the year following their presentation, both those presenting acutely and those referred electively.

Patients and methods:

A retrospective study of 95 treatment-naïve patients (47 acute, 48 elective) referred for management of urolithiasis was undertaken. The analysis included all imaging modalities related to stone disease for both patient groups within one year following presentation. The total effective dose (mSV) in one year was calculated by summing the dose for each individual radiation exposure.

Results:

An average of 5.6 radiological investigations (range 1–14) was carried out for acute patients and 4.57 for elective patients (range 1–11). The mean total effective dose was 14.45 mSV for the acute cases and 12.87 mSV for the elective cases. The maximum radiation dose reached 30.1 mSV in acute patients and 36.51 mSV in elective ones. None of the patients exceeded the maximal annual dose recommended by the International Commission on Radiological Protection (ICRP) of 50 mSV.

Conclusion:

Management of acute and elective urolithiasis patients can be achieved with acceptable radiation dose exposure. It is extremely important to keep the hazards of radiation in mind whilst managing patients with urolithiasis and clinicians need to remember adherence to the ALARA principle.