Skip to main content
Log in

Standard vs. reduced-radiation-dose CT in the tracing of the ureter

  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To assess the effectiveness of reduced-radiation-dose computed tomography (CT) protocols in the tracing of the ureter in patients with suspected renal colic.

Methods

The study was approved by our institutional review board, and informed consent was obtained from the participants. From July 2012 to April 2014, 310 consecutive patients with suspected urolithiasis were recruited to undergo unenhanced CT at 280 (n = 62), 200 (n = 62), 140 (n = 62), 100 (n = 62), and 70 (n = 62) reference mA seconds (mAs) while keeping other imaging parameters constant. Images were independently and randomly reviewed by two radiologists blinded to the study to determine the tracing rates of the ureter and the acceptable rates of image quality according to different tube charge settings.

Results

A significant linear association was noted between tube charge settings, the rates for tracing of the ureter, and the acceptability of image quality (linear-by-linear association; p = 0.000 in all rates for both readers). The 140 reference mAs is the point at which the tracing rates deteriorate rapidly, with the tracing rate of 41.5% (95% CI 32.6%–51.0%) in reader 1 and 51.9% (95% CI 42.5%–61.2%) in reader 2, and with the acceptable rate of 82.3% (95% CI 70.8%–90.0%) in reader 1 and 96.8% (95% CI 88.3%–99.8%) in reader 2.

Conclusion

Decreasing the tube charge settings from 280 to 70 reference mAs resulted in a significant reduction in the tracing rate of the ureter, with 140 reference mAs being the breaking point.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Smith RC, Rosenfield AT, Choe KA, et al. (1995) Acute flank pain: comparison of non-contrast-enhanced CT and intravenous urography. Radiology 194(3):789–794. doi:10.1148/radiology.194.3.7862980

    Article  CAS  PubMed  Google Scholar 

  2. Kambadakone AR, Eisner BH, Catalano OA, Sahani DV (2010) New and evolving concepts in the imaging and management of urolithiasis: urologists’ perspective. Radiographics 30(3):603–623. doi:10.1148/rg.303095146

    Article  PubMed  Google Scholar 

  3. Smith RC, Coll DM (2000) Helical computed tomography in the diagnosis of ureteric colic. BJU Int 86(Suppl 1):33–41

    PubMed  Google Scholar 

  4. Smith RC, Verga M, McCarthy S, Rosenfield AT (1996) Diagnosis of acute flank pain: value of unenhanced helical CT. AJR Am J Roentgenol 166(1):97–101. doi:10.2214/ajr.166.1.8571915

    Article  CAS  PubMed  Google Scholar 

  5. Cohnen M, Poll LJ, Puettmann C, et al. (2003) Effective doses in standard protocols for multi-slice CT scanning. Eur Radiol 13(5):1148–1153. doi:10.1007/s00330-002-1614-9

    PubMed  Google Scholar 

  6. Mettler FA Jr, Huda W, Yoshizumi TT, Mahesh M (2008) Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology 248(1):254–263. doi:10.1148/radiol.2481071451

    Article  PubMed  Google Scholar 

  7. Brenner DJ, Hall EJ (2007) Computed tomography—an increasing source of radiation exposure. N Engl J Med 357(22):2277–2284. doi:10.1056/NEJMra072149

    Article  CAS  PubMed  Google Scholar 

  8. Slovis TL (2002) CT and computed radiography: the pictures are great, but is the radiation dose greater than required? AJR Am J Roentgenol 179(1):39–41. doi:10.2214/ajr.179.1.1790039

    Article  PubMed  Google Scholar 

  9. Jin DH, Lamberton GR, Broome DR, et al. (2010) Effect of reduced radiation CT protocols on the detection of renal calculi. Radiology 255(1):100–107. doi:10.1148/radiol.09090583

    Article  PubMed  Google Scholar 

  10. Jellison FC, Smith JC, Heldt JP, et al. (2009) Effect of low dose radiation computerized tomography protocols on distal ureteral calculus detection. J Urol 182(6):2762–2767. doi:10.1016/j.juro.2009.08.042

    Article  PubMed  Google Scholar 

  11. Katz DS, Venkataramanan N, Napel S, Sommer FG (2003) Can low-dose unenhanced multidetector CT be used for routine evaluation of suspected renal colic? AJR Am J Roentgenol 180(2):313–315. doi:10.2214/ajr.180.2.1800313

    Article  PubMed  Google Scholar 

  12. Sottier D, Petit JM, Guiu S, et al. (2013) Quantification of the visceral and subcutaneous fat by computed tomography: interobserver correlation of a single slice technique. Diagn Interv Imaging 94(9):879–884. doi:10.1016/j.diii.2013.04.006

    Article  CAS  PubMed  Google Scholar 

  13. Katz SI, Saluja S, Brink JA, Forman HP (2006) Radiation dose associated with unenhanced CT for suspected renal colic: impact of repetitive studies. AJR Am J Roentgenol 186(4):1120–1124. doi:10.2214/AJR.04.1838

    Article  PubMed  Google Scholar 

  14. Hinkley DV (1970) Inference about change-point in a sequence of random variables. Biometrika 57(1):1–17

    Article  Google Scholar 

  15. Killick R, Fearnhead P, Eckley IA (2012) Optimal detection of changepoints with a linear computational cost. J Am Stat Assoc 107(500):1590–1598. doi:10.1080/01621459.2012.737745

    Article  CAS  Google Scholar 

  16. Killick R, Eckley IA (2014) changepoint: an R package for changepoint analysis. J Stat Softw 58(3):1–19

    Article  Google Scholar 

  17. McCollough CH, Primak AN, Braun N, et al. (2009) Strategies for reducing radiation dose in CT. Radiol Clin North Am 47(1):27–40. doi:10.1016/j.rcl.2008.10.006

    Article  PubMed  PubMed Central  Google Scholar 

  18. Ekstrom MP (2012) Digital image processing techniques, vol. 2. Cambridge: Academic Press

    Google Scholar 

  19. Singh S, Kalra MK, Hsieh J, et al. (2010) Abdominal CT: comparison of adaptive statistical iterative and filtered back projection reconstruction techniques. Radiology 257(2):373–383. doi:10.1148/radiol.10092212

    Article  PubMed  Google Scholar 

  20. Padole A, Ali Khawaja RD, Kalra MK, Singh S (2015) CT radiation dose and iterative reconstruction techniques. AJR Am J Roentgenol 204(4):W384–W392. doi:10.2214/AJR.14.13241

    Article  PubMed  Google Scholar 

  21. Wall BF, Hart D (1997) Revised radiation doses for typical X-ray examinations. Report on a recent review of doses to patients from medical X-ray examinations in the UK by NRPB. National Radiological Protection Board. Br J Radiol 70(833):437–439. doi:10.1259/bjr.70.833.9227222

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Min Hoan Moon.

Ethics declarations

Funding

This study was funded by a clinical research grant-in-aid from the Seoul Metropolitan Government Seoul National University (SMG-SNU) Boramae Medical Center (03-2013-10).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sung, C.K., Moon, M.H., Son, H. et al. Standard vs. reduced-radiation-dose CT in the tracing of the ureter. Abdom Radiol 42, 900–907 (2017). https://doi.org/10.1007/s00261-016-0929-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-016-0929-y

Keywords

Navigation