Background Computed tomography (CT) is a type of medical imaging that uses x-rays to generate cross-sectional images of the body. Although CT improved the limitations in conventional radiography, the effective dose for CT procedures is higher than the dose of a conventional radiographic examination of the same part. For instance, the radiation dose for kidney, ureter, and bladder (KUB) in. In Timothy's case, the effective dose for an abdominopelvic CT examination was 6.5 mSv (Fig. 2). According to BEIR VII, of 100,000 male patients who receive an effective dose of 6.5 mSv at age 10, 94 individuals (0.094%) in this group would be expected to eventually have cancer, which would be fatal in 46 cases (0.046%)
The mean effective radiation dose was 1.04 ± 0.41 mSv. Of the ULD CTs that detected ureterolithiasis, 38% lacked visibility on KUB/CT scout film and had no associated hydronephrosis, suggesting that they would be missed with a combination of KUB and ultrasound The typical fetal radiation dose for a routine CT of the abdomen and pelvis is 25 mGy. 6 With modern CT scanners that use automated exposure control the dose is about 13 mGy. 7,8 Low-dose CT KUB protocols can result in doses on the order of 10 mGy to 11 mGy 6 (Table 1) CT KUB scans should commence sufficiently cranially to include both kidneys in their entirety but be well collimated thereafter in order to minimise patient dose. Background: In patients with acute flank pain CT KUB is the favoured imaging technique to confirm the diagnosis of urinary tract calculi, in accordance with the Royal College of. CT KUB: What is It? CT KUB is a short form for computer tomography of Kidneys, Ureters and Bladder. It is also called as CT Urogram. This is a type of medical imaging. It uses x-rays to create images of the urinary system of a patient. It consists of intravenous or intra-venous injection of a contrast medium In general the health effects of ionising radiation are dependent on the dose received. While low doses increase the risk of cancer later in life, very high doses act like a poison and can be fatal
CT KUB is the most accurate investigation in suspected ureteric colic and a low-radiation-dose (LD) CT technique can be used in most cases (patients with a high BMI (>=30) might not be suitable for low dose CT KUB Ref 10) CT and computed radiography: the pictures are great, but is the radiation dose greater than required? AJR Am J Roentgenol 2002; 179:39-41. Crossref, Medline, Google Scholar; 16 Kalra MK, Prasad S, Saini S, et al. Clinical comparison of standard-dose and 50% reduced-dose abdominal CT: effect on image quality. AJR Am J Roentgenol 2002; 179:1101-1106 With a median value scan range of 36.1 cm, the CTDI vol, DLP, and effective dose were found to be 10.7 mGy, 390.3 mGy cm and 6.2 mSv, respectively. The mean cancer risks for males and females were estimated to be respectively 25 and 46 out of 100,000 procedures with effective doses between 4.2 mSv and 10.1 mSv Well, CT KUB refers to computed tomography of the kidney, ureter, and bladder[i]. Of course, we are talking about the radiation dose here [v]. It is imperative that the patients undergoing a CT KUB must ask their doctors about the radiation quotient. Also, checking with the radiologist about the contrast media that we mentioned earlier is. .6,7These latter have been described since the turn of the millennium and expose the patient to no more radiation than a KUB (0.69 mSv) with a sensitivity and specificity EXACTLY the same as the typical CT scan
Wall BF, Hart D. Revised radiation doses for typical x‐ray examinations. The British Journal of Radiology 70:437‐439; 1997 (5,000 patient dose measurements from 375 hospitals) Together, dedicated to improving the understanding of radiation risks from medical imaging. Calculate your dose and estimate cancer risk from studies including CT scans, x-rays, nuclear scans and interventional procedures
The three IRs enable 20-33% radiation dose reduction in kidney stone CT examinations compared with the FBP technique without any image quality concerns. The radiation dose and image quality were comparable among these three IR algorithms. Keywords: CT, dose monitoring, iterative reconstruction, kidney stones, radiation dose causes of pain can be detected. However, CT is a high-radiation-dose technique. The effective dose of CT KUB has been estimated to be between 3 and 5mSv, which is up to three times that for IVU . It is important to estab-lish that requests are appropriate and that the test will provide information to improve patient diagnosis, treatment and. ULDCT 48% lower radiation dose than KUB KUB 0.64mSv ULDCT 0.31mSv CT 9.3mSv Ultra Low Dose CT True Positive 39 True Negative 41 False Negative 2 False Positive 1 Both measure <2mm Diagnostic Performance PPV = 98% NPV = 95% Sensitivity = 95% Specificity = 98 MGH Webster Center for Radiation Dose Research and Education CT dose - 1.06 mSv CT dose - 1.6mSv CT dose - 6.8 mSv Image Quality is in the Eye of the Beholder CT dose - 18 mSv CT dose -2.2 mSv 430 lbs 162 lbs 151 lb
A plain x-ray (KUB) carries a dose of 0.7 mSv as compared to a much higher dose of 15 mSv from a CT scan. For comparison, the annual background radiation most individuals experience is 3.86 mSv just from the environment. Therefore, getting a KUB carries a relatively low dose compared to getting a repeat CT scan . PhD, et al. Dose Performance of a 64 Channel Dual Source CT Scanner. Radiology, 2007;243:775-784 FETAL RADIATION DOSE ESTIMATES FROM COMMONLY USED RADIOPHARMACEUTICALS (Taken from the Radiation Internal Dose Information Center, RIDIC, dose estimate tables • A non-contrast CT-KUB radiation dose: approximately 4.7mSv compared to 1.5mSv for IVU • Ultra-low dose CT (ULDCT) lowers radiation exposure (0.6-2mSv), but at the expense of lower sensitivity (68-86%) for small (<3mm) ureteric stones
Given the radiation dose associated with CT KUB, the use of repeated CT scans has been an area of concern. The UK National Dose Reference Level for CT scans of the abdomen and pelvis for KUB examinations assessing stones/colic is 745 mGy cm. This equates to an effective dose of 6.44 mean radiation dose (mSv), based upon a. KUB could be used for follow‐up in 63% of cases. All stones seen on CT scout were also visible on KUB. Scout detected 75% of stones visible on KUB. We suggest CT scout film should be reported before proceeding to KUB. If the stone is visible on CT scout film, then the decision to use KUB for follow‐up can be made. This minimizes radiation.
Consider whether you can 'justify' high dose radiation studies such as CT scans in young children and young adults and in patients with chronic recurring (CT KUB = 3 years) (CT Trauma pan scan = 10 years) Low 1 in 10,000 to 1 in 1,000 NOTE Unenhanced helical CT for kidney, ureter and bladder (CT KUB) has become the standard investigation for renal colic [1,2].Its superior sensitivity and specificity has led to the demise in popularity of intravenous urogram (IVU) , although there remain some concerns about radiation dose .At our institution, CT KUB has been the first-line investigation for patients suspected of having acute.
In conclusion, our study suggests that by using advanced ultra-low-dose iterative reconstruction algorithms, it is feasible to reduce radiation dose at non-contrast CT to a level below that of a typical 2-view KUB while still maintaining adequate diagnostic accuracy for the detection of clinically significant urolithiasis Except for a very small proportion of patients, the lower radiation dose of the CT KUB investigation protocol was suitable for most patients, including the elderly. The protocol at London North West University Healthcare NHS Trust calls for all adults presenting with ureteric colic to have a routine emergency CT KUB. A CTU is ordered only if a. Dual energy CT KUB scans can reliably distinguish urate from non-urate calculi. CT imaging around metal implants. Volume Computed Tomography Dose Index (CTDIvol) is a standardized parameter to measure Scanner Radiation Output CTDIvol is NOT patient dose CTDIvol is reported in units of mGy for either a 16-cm (for head exams) or 32-cm (for. In general, the radiation dose associated with a routine abdominal CT has a radiation dose similar to three years of average background radiation.  Recent studies on 2.5 million patients  and 3.2 million patients  have drawn attention to high cumulative doses of more than 100 mSv to patients undergoing recurrent CT scans within a. If you are concerned about monitoring progression of a rock and radiation dose (and your patients wallet), getting KUBs ($40 a pop, 40CXR equivalent) is going to be a better deal than repeated CTs ($500 a pop, 500CXR equivalents
Reducing radiation dose. Lower dose CT protocols may be used in follow-up scans of known or younger patients at the price of slightly lower image quality. Most patients undergo many studies for surveillance of their disease; hence, this can result in significant radiation dose reduction. Methods usually applied for that include: lower mAs (~40 mA Equivalent period of natural background radiation 1 Lifetime additional risk of fatal cancer per examination 2; Limbs and joints (except hip) < 0.01 < 1.5 days: 1 in a few million: Teeth (single.
The estimated amount of radiation in a low-dose helical CT procedure is 1.5 mSv (1). Those who have never smoked tobacco products are considered to be at too low a risk of lung cancer to benefit from lung cancer screening CT as a source of population dose (Shrimpton and Wall, 1993). It also demonstrated significant variations in practice between CT centres for similar types of examination and hence the scope for improvement in patient protection (Shrimpton and Wall, 1992). In addition, the work underpinned the development of specific reference dose quantities for CT
The effective dose of a standard CT KUB examination has been estimated to be between 3 and 5 mSv, which is up to three times that for intravenous pyelography. However, radiation dose in CT KUB is gradually decreasing with the introduction of ultra-low radiation dose CT KUB (0.5-0.7 mSv) CT radiation dose. Radiation dose varies widely between individual patients and between radiology providers. Image intensiﬁ ers may be an additional signiﬁ cant source tenth to a twentieth of the dose from a CT KUB and a considerably smaller fraction of a CT IVP. In Australia the current system of multiple unrelated providers, each with. CT emits a powerful dose of radiation, in some cases equivalent to about 200 chest X-rays, or the amount most people would be exposed to from natural sources over seven years. That dose can alter.
Patients with higher BMIs received greater doses for both XR-KUB and CT-KUB. Conclusion: The Effective-Dose of XR-KUB was on average 5-fold higher than historically referenced. Furthermore, for 1-in-3 patients, the radiation Effective-Dose of CT-KUBs was less than that of the preceding XR-KUB In our study, only 96% of CT KUB scans terminated at or below the T10 level, and only 15% commenced at the level of the pubic symphysis. The radiation dose administered in our study is within the threshold of national practice. Extending the FoV increases the dose administered to.. Low dose protocols have been developed with the goal of reducing radiation dose with adequate image quality. Although the sensitivity and the specificity of CT is the highest, many can be diagnosed with combination of KUB and ultrasound. CT can be utilized in equivocal cases Does ultra-low-dose CT with a radiation dose equivalent to that of KUB suffice to detect renal and ureteral calculi? J. Comput. Assist. Tomogr. 30(1), 44-50 (2006). Kim BS, Hwang IK, Choi YW et al. Low-dose and standard-dose unenhanced helical computed tomography for the assessment of acute renal colic: prospective comparative study
In the U.S., the abdomen, which in the Surgical arena includes the pelvis because, I suppose, the peritoneal cavity and the retroperitoneum involve both, is conceptually divided, in the Radiologic arena, into the two regions as if they're separate.. There is a trend towards a more discriminate use of CT of the kidneys, ureters and urinary bladder (KUB) in patients with clinical uncomplicated acute renal colic, particularly in young female patients, in whom there is a relatively high incidence of negative CT examinations, and in whom radiation is more of an issue 8, Our CT scanners keep radiation doses as low as possible while still obtaining high-quality images. But in reality, the amount of radiation from a single imaging test really is not that much. In general, the benefits of imaging tests far outweigh the radiation risks A CT KUB - a widely-used term which is convenient shorthand, but technically incorrect - is a CT study of the abdomen and pelvis without any IV or oral contrast. It is the usual test for someone with a suspected kidney or ureteral stone; it's fa..
Each CT scan delivers 1 to 10 mSv, depending on the dose of radiation and the part of your body that's getting the test. A low-dose chest CT scan is about 1.5 mSv. The same test at a regular dose. PURPOSE: To evaluate a low-dose, nonenhanced helical computed tomographic (CT) protocol in the detection of ureteric stones and measure the associated effective dose equivalent (H E) of radiation. MATERIALS AND METHODS: Sixty patients suspected of having renal colic and referred by emergency department physicians underwent nonenhanced helical CT with 7-mm collimation and a 2:1 pitch and then.
Parameters that can be set on a CT scanner describing the level of noise in acquired CT images. • By altering these parameters one can indirectly alter radiation dose • Thus IR tools are actually noise reduction tools which allow us to scan at lower radiation doses, but create images of diagnostic qualit Concerns over radiation exposure, especially in young stone patients, have led to the development and evaluation of reduced-dose CT regimens [11-20]. If CT is being performed to evaluate for renal or ureteral stones, a low-dose protocol should be performed . Techniques for lowering dose include using a lower kVp, lower tub CT KUB has the advantages of speed and certainty in diagnosing stones acutely and excluding other pathology, but at a cost of significantly more radiation exposure. CT IVP (with possible three‐dimensional reconstruction) has an even higher radiation dose but can provide much improved imaging particularly when planning renal surgery 10 -Risks to patient- ie radiation exposure -Cost to come up with decision trees . Imaging Guidelines . Panel Considerations • Computed Tomography (CT) • Ultrasound (US) • Plain abdominal radiography (KUB) • Intravenous pyelograms (IVP) KUB. IVP. CT Urogram. Effective Dose (mSV) Imaging Study . Neisius A, et al. J Urol 2013
This CT technique results in a concomitant decrease in radiation dose of 25% from multi detector row CT and 42% for single detector row CT. This technique has been incorporated into our routine protocol for detection of stones and, in our opinion, promises particular benefit to young patients who experience repeat stone formation For most women, there's very little risk from routine x-ray imaging such as mammography or dental x-rays. But many experts are concerned about an explosion in the use of higher radiation-dose tests, such as CT and nuclear imaging. Over 80 million CT scans are performed in the United States each year, compared with just three million in 1980 All individuals underwent pre procedural imaging X-ray KUB, U/S and CT. On these imaging modalities obstruction of urinary tract and stones were determined. X-ray KUB was done as a guide for U/S exam only. Ureteral stones were confirmed in 190 patients. Specificity for ct was 100% whereas X-ray KUB and U/S was 94% and 76% respectively
Summary: Optimisation of CT KUB scanning for renal colic, suggesting that the optimal position to begin a CT KUB scan in these patients is at the T10 vertebral level. References: Smith-Bindman R, Lipson J, Marcus R, et al. Radiation Dose Associated With Common Computed Tomography Examinations and the Associated Lifetime Attributable Risk of Cancer Renal ultrasonography, in spite of its lower sensitivity, is the preferred initial imaging modality for children because of radiation concerns. 38 Low-dose CT should be considered if renal ultrasonography is not diagnostic for children in whom a ureteral stone is still suspected. 39-40 Renal ultrasonography is the initial imaging modality of choice for pregnant patients with suspected colic. For instance, the radiation dose for Kidney, Ureter, and Bladder (KUB) in conventional radiography is 0.7mSv, whereas, in the CT scan is 10mSv. Therefore, this study aimed to evaluate the patient radiation dose delivered in unenhanced CT-KUB examinations using two CT machines in compliance with the American College of Radiology (ACR) standards.
Keywords: Dose length product, patient dose, CT examination, kidney ureter bladder (KUB) 1. Introduction The increased use of diagnostic imaging requiring the use of ionizing radiation the rapidly expanding use of computed tomography in the emergency setting, the introduction of multi-detector computed tomography (CT) units and newl Radiation dose 0 mSv 1 - 5.5 mSv, mostly lower range (1-2). Proportional to patient build: obese get higher radiation dose From typical annual background radiation = 3 mSv 15 flights from Melbourne to London (via Singapore) = 1 mSv Additional cancer risk due to irradiation 0% 0.015 - 0.05% (3-10 mSv) From typical annua The major limitation to the initial universal acceptance of CT KUB as a first-line test was the significantly higher radiation dose incurred by the patient. However, low-dose and ultralow-dose CT protocols have reduced radiation exposure by approximately 50% and 95%, respectively, compared with standard-dose CT, with comparable detection rates.
A total of 1,529 patients were included in the review (475 in the LD group and 1,054 in the ULD group). Using standard dose CT KUB as the reference standard, the sensitivity of LD CT KUB ranged.. • The effective radiation dose during unenhanced CT 2.8 to 13.1 mSv for men / 4.5 to 18 mSv for women • Techniques for Reduction of Radiation dose-Limit scanning area (not typical Abd+Pelvis exam) - Increase in axial slice thickness to 5mm from 1-3 mm and include 2.5-3 mm coronal reconstructions-Lower dose CT exam ( noise index, kVp, pitch Hospital Episode Statistic analyses showed over 90 000 patients presented to emergency departments in England in 2014 requiring treatment of renal colic, representing a 20% increase over the previous 10 years. 1 Urologists (and patients) are fortunate that low dose (less than 3 millisieverts) computed tomography of the kidneys, ureters and bladder (CT KUB) is over 93% specific (and 97%. Tradeoffs in CT Image Quality and Radiation Dose Michael F. McNitt-Gray, PhD, DABR Associate Professor Dept. Radiology David Geffen School of Medicine at UCLA Image Quality Image quality has many components and is influenced by many technical parameters. While image quality has always been Ionizing radiation deposits energy in the matter being irradiated. The quantity used to express this is the absorbed dose, a physical dose quantity that is dependent on the level of incident radiation and the absorption properties of the irradiated object.Absorbed dose is a physical quantity, and is not a satisfactory indicator of biological effect, so to allow consideration of the stochastic. Radiation Dose Reference Chart: Download a reference chart listing common imaging examination doses, updated to reflect the data presented in NCRP Report No. 184.: Download a customizable medical imaging fact card for your patients.. Download a medical imaging tent card for your patients