Low dose computed tomography KUB region for management of urolithiasis in Indian scenario

Abstract

Background: The incidence, prevalence and recurrence of urolithiasis are very high; especially in the north-western part of India. Ultrasonography has decreased sensitivity and specificity as compared with NCCT for detection of both renal and ureteral calculi. Drawbacks of NCCT in terms of radiation exposure, cost and repeatability can be overcome by Low dose NCCT protocols. Low dose NCCT can be an investigation with high diagnostic accuracy, less radiation hazards and financial acceptability. Aim of this study was to evaluate use of Low dose CT-KUB over ultrasound (US) for diagnosis of urolithiasis, in Indian scenario.Methods: This is a prospective study, at Tertiary Care Hospital. Patients with acute flank pain, who underwent both US and Low dose NCCT within an interval of 24 hours, at Tertiary Care Hospital. Helical CT scanner (Phillips 128 slice medical systems) with exposure factors setting of KVp 120 and mAs 70 was used.Results: A total of 136 Patients with mean age of 33.01 years (range 19-62 years, SD 10.93), were examined with 82(60.29%) males and 54(39.7%) females, average BMI was 25.07(range 17.2 to 35.02). Low Dose NCCT has a sensitivity of 95% (CI of 89.43-98.14%) and specificity of 87.50% (95% CI of 61.65-98.45%) in the diagnosis of urolithiasis. Mean effective dose of radiation administered in low dose CT-KUB was 1.8-2.2 mSv.Conclusions: In view of information, reliability, repeatability, radiation exposure and cost acceptability; unenhanced Low dose CT-KUB region should be the preferred investigation for the management of urolithiasis, in the scenario of a developing country.