Background: 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. Method: 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. Results: 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. Conclusion: This data supports moving away from XR-KUBs for the investigation of urolithiasis, particularly in patients with a high BMI.

Cytological techniques are used as first line diagnostic tool in suspected lung tumors, based on which crucial management decisions are made. Bronchial brush (BB) and bronchial wash (BW) are two commonly employed techniques with variable diagnostic yield. This study compared the efficacy of BB and BW in diagnosing lung tumors. Aims: To study sensitivity of BW and BB cytology in diagnosing lung tumours by correlating with biopsy as gold standard. To study the efficacy of BW and BB in typing the lung tumors. Methods and Material: A cross sectional observation study for a period of 5 years was done. A total of 176 cases, suspected of lung cancer between January 2015 and December 2019 were selected, where cytology samples of BB or BW or both along with biopsy were obtained. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated separately for BB and BW. Statistical analysis used: All data were analyzed using SPSS software version 20. Results: Sensitivity of BB was significantly higher (77.8%) when compared to BW (51.9%), while specificity was better for BW (90.9%) compared to BB (80%). Positive predictive value of BW was higher (97.6%) compared to BB (93.3%). Negative Predictive value of BB and BW was 50% and 21.3% respectively. BB showed better accuracy (78.3%) compared to BW (56.85). Conclusions: BB is a much superior technique in diagnosing lung tumors, as it demonstrates far better sensitivity and accuracy. However, since specificity is higher with BW, both techniques should be concurrently used to obtain maximum diagnostic yield. BB has better efficacy in typing squamous cell carcinoma followed by small cell carcinoma and adenocarcinoma while BW is superior in typing small cell carcinoma followed by squamous cell carcinoma and adenocarcinoma

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