Percutaneous kidney stone surgery and radiation exposure: A review
During the past 3 decades, radiation exposure (RE) has increased drastically among patients undergoing percutaneous nephrolithotomy (PCNL), thus potentially causing new cases of cancer each year. The effective dose received by patients comes from pre- and post-operative computed tomography (CT) and...
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Elsevier
2020-01-01
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| Series: | Asian Journal of Urology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388219300396 |
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| author | Bohdan Baralo Patrick Samson David Hoenig Arthur Smith |
| author_facet | Bohdan Baralo Patrick Samson David Hoenig Arthur Smith |
| author_sort | Bohdan Baralo |
| collection | DOAJ |
| description | During the past 3 decades, radiation exposure (RE) has increased drastically among patients undergoing percutaneous nephrolithotomy (PCNL), thus potentially causing new cases of cancer each year. The effective dose received by patients comes from pre- and post-operative computed tomography (CT) and intraoperative fluoroscopy (FL). We reviewed literature to find novel techniques and approaches that help to decrease RE of patients and personnel. We performed PubMed search using keywords percutaneous nephrolithotomy, intraoperative fluoroscopy, radiation exposure, imaging, percutaneous access, ultrasound, computed tomography, endoscopy, reconstruction, innovations, and augmented reality. Forty-four relevant articles were included in this review. As much as 20% of patients with first diagnosed urolithiasis exceed background RE level almost 17-fold. For diagnosing purposes using low-dose and ultra-low-dose CT, as well as low-dose dual energy scan protocols can be efficient ways to decrease RE while maintaining decent accuracy. Patients with urinary stones can be effectively monitored with digital tomosynthesis, ultrasound alone or ultrasound combined with plain film of the abdomen. Percutaneous access (PCA) into the kidney can be performed with reduced or even no RE, using novel PCA methods. REs from conventional imaging techniques during diagnosis and treatment increase probability of non-stochastic radiation effects. Urologists should be aware of protocols that decrease RE from CT and FL in diagnosis and management of urinary stones. Consideration of recently developed imaging modalities and PCA techniques will also aid in adherence to the “as low as reasonably achievable” principle. Keywords: PCNL, Urolithiasis, Reduction of radiation exposure, Percutaneous kidney access, Diagnostic imaging, Training |
| format | Article |
| id | doaj-art-84846e6a98b04354b8af080cf978f5d3 |
| institution | OA Journals |
| issn | 2214-3882 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj-art-84846e6a98b04354b8af080cf978f5d32025-08-20T02:13:26ZengElsevierAsian Journal of Urology2214-38822020-01-0171101710.1016/j.ajur.2019.03.007Percutaneous kidney stone surgery and radiation exposure: A reviewBohdan Baralo0Patrick Samson1David Hoenig2Arthur Smith3Urology Department, National Pirogov Memorial Medical University, Vinnytsya, UkraineDepartment of Urology, Smith Institute for Urology, Northwell Health, New Hyde Park, NY, USA; Corresponding author.Department of Urology, Smith Institute for Urology, Northwell Health, New Hyde Park, NY, USADepartment of Urology, Smith Institute for Urology, Northwell Health, New Hyde Park, NY, USADuring the past 3 decades, radiation exposure (RE) has increased drastically among patients undergoing percutaneous nephrolithotomy (PCNL), thus potentially causing new cases of cancer each year. The effective dose received by patients comes from pre- and post-operative computed tomography (CT) and intraoperative fluoroscopy (FL). We reviewed literature to find novel techniques and approaches that help to decrease RE of patients and personnel. We performed PubMed search using keywords percutaneous nephrolithotomy, intraoperative fluoroscopy, radiation exposure, imaging, percutaneous access, ultrasound, computed tomography, endoscopy, reconstruction, innovations, and augmented reality. Forty-four relevant articles were included in this review. As much as 20% of patients with first diagnosed urolithiasis exceed background RE level almost 17-fold. For diagnosing purposes using low-dose and ultra-low-dose CT, as well as low-dose dual energy scan protocols can be efficient ways to decrease RE while maintaining decent accuracy. Patients with urinary stones can be effectively monitored with digital tomosynthesis, ultrasound alone or ultrasound combined with plain film of the abdomen. Percutaneous access (PCA) into the kidney can be performed with reduced or even no RE, using novel PCA methods. REs from conventional imaging techniques during diagnosis and treatment increase probability of non-stochastic radiation effects. Urologists should be aware of protocols that decrease RE from CT and FL in diagnosis and management of urinary stones. Consideration of recently developed imaging modalities and PCA techniques will also aid in adherence to the “as low as reasonably achievable” principle. Keywords: PCNL, Urolithiasis, Reduction of radiation exposure, Percutaneous kidney access, Diagnostic imaging, Traininghttp://www.sciencedirect.com/science/article/pii/S2214388219300396 |
| spellingShingle | Bohdan Baralo Patrick Samson David Hoenig Arthur Smith Percutaneous kidney stone surgery and radiation exposure: A review Asian Journal of Urology |
| title | Percutaneous kidney stone surgery and radiation exposure: A review |
| title_full | Percutaneous kidney stone surgery and radiation exposure: A review |
| title_fullStr | Percutaneous kidney stone surgery and radiation exposure: A review |
| title_full_unstemmed | Percutaneous kidney stone surgery and radiation exposure: A review |
| title_short | Percutaneous kidney stone surgery and radiation exposure: A review |
| title_sort | percutaneous kidney stone surgery and radiation exposure a review |
| url | http://www.sciencedirect.com/science/article/pii/S2214388219300396 |
| work_keys_str_mv | AT bohdanbaralo percutaneouskidneystonesurgeryandradiationexposureareview AT patricksamson percutaneouskidneystonesurgeryandradiationexposureareview AT davidhoenig percutaneouskidneystonesurgeryandradiationexposureareview AT arthursmith percutaneouskidneystonesurgeryandradiationexposureareview |