Detection of Uric Acid Stones in the Ureter Using Low- and Conventional-dose Computed Tomography

Huang, Gene; Engebretsen, Steven; Smith, Jason C.; Wallner, Caroline; Culpepper, David; Creech, Jonathan D.; Ng, Caleb; Andrew, Toby; Chung, Christopher S.; Olgin, Gaudencio; Arnold, Don C.; Baldwin, D. Duane

doi:10.1016/j.urology.2014.02.021

Cited by 12 publications

(4 citation statements)

References 25 publications

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“…These studies have consistently shown that low-dose CT provides a sensitivity and specificity >95 % and is similar to conventional CT for the detection of both renal and ureteral calculi [31,36,37]. Low-dose CT has also shown efficacy in detecting stone composition by measured Hounsfield units [38][39][40][41] and may assist in selecting the correct treatment regimen [42].…”

Section: Reducing Radiation During Work-up For Urolithiasismentioning

confidence: 83%

Techniques for Minimizing Radiation Exposure During Evaluation, Surgical Treatment, and Follow-up of Urinary Lithiasis

Arenas

Baldwin

2015

Curr Urol Rep

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Patients receive significant radiation exposure during the diagnosis, treatment, and follow-up of urinary stone disease. This radiation exposure may result in patient harm and is believed to contribute to the risk for malignancy. This review will present current information to allow surgeons to optimize their diagnostic, treatment, and follow-up regimens to allow optimal care of stone disease patients at the lowest radiation dose possible.

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Section: Reducing Radiation During Work-up For Urolithiasismentioning

confidence: 83%

Techniques for Minimizing Radiation Exposure During Evaluation, Surgical Treatment, and Follow-up of Urinary Lithiasis

Arenas

Baldwin

2015

Curr Urol Rep

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“…Similar to ours, a systematic review de ning ULDCT as effective dose < 1.9 mSv reported that LDCT and ULDCT have high diagnostic accuracy, sensitivity and speci city despite signi cant radiation dose reduction in comparison to SDCT [31], though they may not be as effective in detecting stones < 3 mm in size or in patients with a BMI of > 30 kg/m 2 [32]. Both SDCT and LDCT have high diagnostic accuracy of ureteral uric acid stones, while the detection of uric acid stones is reduced when LDCT is at ≤ 15mAs [33]. Nevertheless, how low can the effective dose actually be still remains unknown.…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Accuracy of Low-Dose Computed Tomography in Diagnosing Urolithiasis: A Systematic Review and Meta-Analysis

Liang

Chang

Wang

et al. 2020

Preprint

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Background: Urolithiasis is a prevalent health issue all over the world,To evaluate the diagnostic accuracy of low-lose computed tomography(LDCT) for detecting urolithiasis. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. PubMed, EMBASE and The Cochrane Library were searched for original diagnostic studies to identify all relevant studies published prior to May 2020. The index test was LDCT, and the reference standards were comprehensive diagnosis or standard-dose CT (SDCT). Results: 17 studies with 1,761 patients and 2,053 stones were included for the quantitative analysis. The pooled sensitivity was 0.95 (95%CI: 0.93-0.97) in patient-based studies and 0.86 (95%CI: 0.76-0.93) in urolithiasis-based studies. The pooled specificity of LDCT were 0.97 (95%CI: 0.95-0.99) in patient-based studies and 0.98 (95%CI: 0.63-1.00) in urolithiasis-based studies. The Fagan nomogram of LDCT for diagnosis of urolithiasis showed that the probability of urolithiasis is 98% if the LDCT scan is positive and 6% if the LDCT scan is negative. The likelihood ratio plot showed that the summary positive pooled likelihood ratio (LRP) and negative likelihood ratio (LRN) for LDCT was in the left upper quadrant(LUQ) area. Conclusions: LDCT has excellent diagnostic value in urolithiasis. LDCT can detect the urolithiasis specifically, but is limited to differentiate the contents of the stones.

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“…Researchers and organizations did a lot of work to put regulations to keep ionizing radiation exposure to the minimum, such as the ALARA concept ("As Low As Reasonably Achievable [10], or modifying the diagnostic techniques such as the low-dose CT scan [11], or modifying the interventions to be performed with lower radiation using pulse fluoroscopy during URS and PCNL [12], or without radiation at all such as the Fluoroless Ureteroscopy [13], and Ultrasound-guided PCNL [14].…”

Section: Introductionmentioning

confidence: 99%

Awareness and implementation of lonizing radiation safety measures among urology community in Egypt: nationwide survey

et al. 2021

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Background To assess awareness of ionizing radiation safety measures among Egyptian Urology Trainees and Urologists and see the effect of radiation safety courses on the adoption of these measures. Methods This Internet-based survey was conducted via https://www.surveymonkey.com/ after approval by the Egyptian Urological Association (EUA). It was sent to all EUA members via email during December 2019. Participation was voluntary and questions included participants’ demographics such as age, gender, years of experience, level of training and type of practice. Other questions assessed some domains such as whether the participant had radiation safety courses, and the extent to which she/he is adopting these measures during daily practice. Results A total of 142 Egyptian urology trainees and urologists responded to this electronic survey. The mean hours of fluoroscopy-guided endourologic procedures per week were 4.3 ± 2.1 h, and only 23% reported that they always wear protective lead aprons. In terms of the thyroid shield, X-ray protective gloves, eye googles, a total of 70% and 89% and 89% reported that they never wore it, respectively. The ALARA principle was known by only 24% of respondents. About 94% denied receiving any radiation safety courses. Participants who received radiation safety course reported significantly shorter FT during URS (p = 0.04), PCNL (p = 0.03) and JJ insertion (p = 0.04) and were significantly more compliant (p = 0.02). In addition, the number of years of experience (< 5y,5-10y,10-15y, > 15y) and the current job level (resident, specialist, consultant, professor) was significantly associated with higher compliance with lead aprons (p = 0.006, p < 0.001, respectively). On regression analysis, previous radiation safety awareness courses were the only predictor of good compliance with radiation safety measures (OR = 2 ± 0.73, p = 0.009). Conclusion There was a lack of awareness and implementation of radiation safety measures among all participants. Receiving radiation safety courses was the only predictor of good compliance with radiation safety measures.

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Detection of Uric Acid Stones in the Ureter Using Low- and Conventional-dose Computed Tomography

Cited by 12 publications

References 25 publications

Techniques for Minimizing Radiation Exposure During Evaluation, Surgical Treatment, and Follow-up of Urinary Lithiasis

Techniques for Minimizing Radiation Exposure During Evaluation, Surgical Treatment, and Follow-up of Urinary Lithiasis

The Diagnostic Accuracy of Low-Dose Computed Tomography in Diagnosing Urolithiasis: A Systematic Review and Meta-Analysis

Awareness and implementation of lonizing radiation safety measures among urology community in Egypt: nationwide survey

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