Radiation Doses to Patients From Extracorporeal Shock Wave Lithotripsy

Abstract

The aim of this study was to determine the radiation doses to patients during extracorporeal shock wave lithotripsy (ESWL) and compare them with the available bibliographical data. In this method localization of the renal stones is attained by the use of fluoroscopy, and thus ESWL is included among those medical practices associated with patient radiation exposure. The entrance surface dose was measured using 3-4 thermoluminescent dosimeters positioned on the patients' backs at the entrance surfaces of the two x-ray beams for 50 ESWL procedures. Fluoroscopy time and number of spot films were also recorded. The average entrance surface dose at the patient's side with the renal stone was estimated to be 76.5 mGy for the oblique x-ray beam and 44.5 mGy for the PA x-ray beam. The mean fluoroscopy time was 204 s while 4 spot films were acquired on average. The mean effective dose (E) was estimated as 1.63 mSv per patient. The mean entrance surface dose values recorded in this study are comparable to but smaller than the values reported in the literature for ESWL, while the mean fluoroscopy time is within the range of values reported by other authors. On the other hand, the estimated E value is relatively higher compared to the corresponding values given in the literature based on patient measurements. However, it is comparable to recent published data acquired using extended measurements in an anthropomorphic phantom.

Radiological Protection in Fluoroscopically Guided Procedures Performed Outside the Imaging Department

“…However, it must be remembered that the dose from ESWL is always added to the dose from pre-and post-treatment KUB and intravenous urography procedures (Sandilos et al, 2006). For other urological procedures, typical effective doses range from <1 mSv for abdominal radiography to a mean of approximately 7 mSv for nephrostomy.…”

Ultrasonography Is Not Inferior to Fluoroscopy to Guide Extracorporeal Shock Waves during Treatment of Renal and Upper Ureteric Calculi: A Randomized Prospective Study

“…Imaging studies may also be performed for other purposes. Also, the operator's exposure to ionizing radiation should be taken into account [18]. Interestingly, however, Ordon and colleagues demonstrated that a small but significant increase in fluoroscopy time correlated with an increase in SWL success rates [19].…”

A Passive Acoustic Device for Real-Time Monitoring of the Efficacy of Shockwave Lithotripsy Treatment

“…1b), and the strategy adopted almost universally by ESWL operators is to deliver a predefined number of shockwaves (typically around 3,000). Finally, the operator has a significant role in minimizing the ionizing radiation exposure by restricting the fluoroscopy exposure time and number of spot films within the constraint of achieving accurate shockwave targeting of the stone (Sandilos et al 2006). More information on treatment progress and targeting during clinical ESWL may allow the operator to exercise greater control over many of the factors that influence retreatment rate and morbidity.…”