Radiation dose associated with unenhanced CT for suspected renal colic: Impact of repetitive studies

OBJECTIVE. The purpose of our study was to assess the dose of ionizing radiation delivered through the use of unenhanced CT for suspected renal colic by determining the incidence of repeated unenhanced CT examinations and the cumulative radiation dose delivered. MATERIALS AND METHODS. All unenhanced CT examinations for suspected renal colic performed at our institution over a 6-year period were included, and patient age, sex, and multiplicity of examinations were determined. For the adult patient, this protocol prescribes a fixed tube current of 200 mA, 140 kVp, and a nominal slice width of 5 mm. The dose-length product (DLP) was estimated for 15 randomly chosen single-detector CT (SDCT) and MDCT adult flank pain examinations using manufacturer's software. The mean DLPs for SDCT and MDCT were computed and converted to effective doses. Total effective doses were calculated for patients who underwent more than three examinations, and values were compared with established standards. RESULTS. A total of 5,564 examinations were performed on 4,562 patients. Of these patients, 2,795 (61%) were women (mean age, 45.5 +/- 16.2 [SD] years) and 1,731 (38%) were men (mean age, 44.7 +/- 16.4 years), with 144 patients (3%) of pediatric age. The mean effective doses for a single study were 6.5 mSv for SDCT and 8.5 mSv for MDCT. A subset of 176 patients (4%) had three or more examinations, with estimated effective doses ranging from 19.5 to 153.7 mSv. All patients with multiple examinations had a known history of nephrolithiasis. CONCLUSION. Patients with a history of nephrolithiasis and flank pain are at increased risk for serial CT with potentially high cumulative effective doses.