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Radiologic evaluation of children prior to SWL: to what extent they are exposed to radiation?

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Abstract

The objective of this study is to evaluate the average radiation exposure in children with renal stones before SWL treatment. Mean radiation exposure values were evaluated in 110 children before SWL treatment. While some children referred to the emergency department (ED) with colic pain, remaining cases referred to outpatient department (OD). Although low-dose NCCT was performed in ED; KUB and abdominal sonography were first performed in other cases referring to OD where CT has been applied if needed. The type of imaging modality used and the mean radiation exposure were evaluated and comparatively evaluated with respect to the department referred, patient as well as stone related parameters. 49 children referred to ED and 61 children referred to OD. Mean stone size was 7.24 ± 0.29 mm. 62 cases had opaque stones. Mean radiation exposure values were higher in children referring to ED than the other cases. However, there was no significant difference between the two groups regarding the mean number of KUB, IVU and sonographic evaluation performed prior to SWL management. There was a significant correlation between the mean radiation exposure and the stone size as well degree of hydonephrosis in a positive manner. Although a significant correlation was present between the mean radiation exposure and stone opacity in a negative manner; there was no correlation with respect to the other related parameters. Unnecessary use of X-ray based imaging modalities in children could be effectively avoided using KUB and US combination beginning from the diagnostic phase of stone disease.

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Abbreviations

ALARA:

As low as reasonably achievable

CT:

Computed tomography

ED:

Emergency department

HU:

Hounsfield unit

IVU:

Intravenous urography

ICRP:

International Commission on Radiological Protection

KUB:

Kidney-ureter-bladder

mSv:

millisievert

NCCT:

Noncontrast computed tomography

OD:

Outpatient department

SWL:

Shock wave lithotripsy

UTI:

Urinary tract infection

USG:

Ultrasonography

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Authors and Affiliations

  1. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Kartal, Istanbul, Turkey

    Bilal Eryildirim, Cemal Goktas, Ovunc Kavukoglu & Kemal Sarica

  2. Lutfi Kirdar Training and Research Hospital, Radiology Clinic, Istanbul, Turkey

    Ozlem Turkoglu

  3. Medistate Hospital Urology Department, Istanbul, Turkey

    Rasim Guzel

Authors
  1. Bilal Eryildirim
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  2. Ozlem Turkoglu
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  3. Cemal Goktas
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  4. Ovunc Kavukoglu
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  5. Rasim Guzel
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  6. Kemal Sarica
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Corresponding author

Correspondence to Bilal Eryildirim.

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Funding

This study was not funded by any institution.

Conflict of interest

Bilal Eryildirim, Ozlem Turkoglu, Cemal Goktas, Ovunc Kavukoglu, Rasim Guzel and Kemal Sarica declares that he has no conflict of interest.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

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Eryildirim, B., Turkoglu, O., Goktas, C. et al. Radiologic evaluation of children prior to SWL: to what extent they are exposed to radiation?. Urolithiasis 46, 485–491 (2018). https://doi.org/10.1007/s00240-017-1008-8

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  • DOI: https://doi.org/10.1007/s00240-017-1008-8

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