Abstract
Background: Urolithiasis is approximate to11% of men and 7% of women.1 Helical CT scan has now become the “gold standard” for diagnosing both renal and ureteric calculi.2 Reducing the tube charge from 100 to 30 MAs led to comparable detection of the stones while reducing radiation exposure by up to 70%.3
Aim of the study: This study conducted a comparison between low and standard doses of CT technology in the diagnosis of ureterolithiasis. The use of low-dose parameters has been shown to reduce radiation exposure while maintaining diagnostic accuracy in most patients
Patients and method: An observational and prospective study conducted on 120 patients, 72 males and 48 females, aged between (19 -50) years, who attended the kidney and urinary tract Diseases Consultation Clinic in Al-Hussien Teaching Hospital during the period from June 2023 to January 2024 in Al Nasiriyah City, Thi-Qar Province, Iraq. All patients suffered from ureterolithiasis and who underwent both SDCT and LDCT, respectively in the same day, was performed via Revolution EVO, GE Healthcare, Japan, without intravenous or oral contrast.
Results: The mean age of patients in this study was 30.8±9.42 years, the mean weight of patients was 81.03±11.11 kg, the mean height was 164.97±7.82 cm, and lastly, the mean BMI was 29.89±4.59 kg/m2. Most of the patients in this study had only one stone (50%), and 60% of those had stones at the distal ureter, 19% at the mid ureter, and 21% at the proximal ureter. Finally, most of the patients had stones on the left side of the body (67%). There was highly significant difference in Total Effective Dose between both protocols, it was 13.39 ± 1.04 mSv in SDCT compared to 1.34 ± 0.44 mSv in LDCT, with a p-value less than 0.001.
Conclusion: A significantly decreased dosage index protocol may not be a perfect examination, but it could be a viable substitute for SDCT scans for evaluating suspected stones, especially in younger patients who are improbable to have other medical conditions and who need follow up.
Recommendations: There is an urgent need for more studies from various Iraqi governorates, with a larger sample size, to confirm the results of this study, and may reduce the number of patients who undergo standard radiation dose.