No AccessJournal of UrologyAdult Urology1 Dec 2013

Radiation Exposure in Urology: A Genitourinary Catalogue for Diagnostic Imaging

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    Computerized tomography use increased exponentially in the last 3 decades, and it is commonly used to evaluate many urological conditions. Ionizing radiation exposure from medical imaging is linked to the risk of malignancy. We measured the organ and calculated effective doses of different studies to determine whether the dose-length product method is an accurate estimation of radiation exposure.

    Materials and Methods:

    An anthropomorphic male phantom validated for human organ dosimetry measurements was used to determine radiation doses. High sensitivity metal oxide semiconductor field effect transistor dosimeters were placed at 20 organ locations to measure specific organ doses. For each study the phantom was scanned 3 times using our institutional protocols. Organ doses were measured and effective doses were calculated on dosimetry. Effective doses measured by a metal oxide semiconductor field effect transistor dosimeter were compared to calculated effective doses derived from the dose-length product.


    The mean ± SD effective dose on dosimetry for stone protocol, chest and abdominopelvic computerized tomography, computerized tomography urogram and renal cell carcinoma protocol computerized tomography was 3.04 ± 0.34, 4.34 ± 0.27, 5.19 ± 0.64, 9.73 ± 0.71 and 11.42 ± 0.24 mSv, respectively. The calculated effective dose for these studies Was 3.33, 2.92, 5.84, 9.64 and 10.06 mSv, respectively (p = 0.8478).


    The effective dose varies considerable for different urological computerized tomography studies. Renal stone protocol computerized tomography shows the lowest dose, and computerized tomography urogram and the renal cell carcinoma protocol accumulate the highest effective doses. The calculated effective dose derived from the dose-length product is a reasonable estimate of patient radiation exposure.


    • 1 : NCRP Report No. 160: Ionizing radiation exposure of the population of the United States, medical exposure—are we doing less with more, and is there a role for health physicists?. Health Phys2009; 97: 1. Google Scholar
    • 2 : Radiologic and nuclear medicine studies in the United States and worldwide: frequency, radiation dose, and comparison with other radiation sources—1950-2007. Radiology2009; 253: 520. Google Scholar
    • 3 : Computed tomography–an increasing source of radiation exposure. N Engl J Med2007; 357: 2277. Google Scholar
    • 4 : Projected cancer risks from computed tomographic scans performed in the United States in 2007. Arch Intern Med2009; 169: 2071. Google Scholar
    • 5 : New ICRP recommendations. J Radiol Prot2008; 28: 161. Google Scholar
    • 6 : American College of Radiology white paper on radiation dose in medicine. J Am Coll Radiol2007; 4: 272. Google Scholar
    • 7 : Effective dose determination using an anthropomorphic phantom and metal oxide semiconductor field effect transistor technology for clinical adult body multidetector array computed tomography protocols. J Comput Assist Tomogr2007; 31: 544. Google Scholar
    • 8 Bencomo JA, Chu C, Tello VM et al: Anthropomorphic breast phantoms for quality assurance and dose verification. J Appl Clin Med Phys; 5: 36. Google Scholar
    • 9 : Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology2008; 248: 254. Google Scholar
    • 10 : Validating methodologies for evaluation of patient doses submitted to chest x-ray examinations. In: . Berlin: Springer2009: 400. Google Scholar
    • 11 : CT dose: how to measure, how to reduce. Health Phys2008; 95: 508. Google Scholar
    • 12 : Estimating effective dose for CT using dose-length product compared with using organ doses: consequences of adopting International Commission on Radiological Protection publication 103 or dual-energy scanning. AJR Am J Roentgenol2010; 194: 881. Google Scholar
    • 13 : Assessment of Patient Dose in CT. NRPB-PE/1/2004. Chilton, United Kingdom: National Radiological Protection Board2004. Google Scholar
    • 14 : Doses from Computed Tomography (CT) Examinations in the UK: 2003 Review. NRPB-W67. Chilton, United Kingdom: National Radiological Protection Board2005. Google Scholar
    • 15 Cristy M: Active bone marrow distribution as a function of age in humans. Phys Med Biol May; 26: 389. Google Scholar
    • 16 : Radiation-related cancer risks at low doses among atomic bomb survivors. Radiat Res2000; 154: 178. Google Scholar
    • 17 United States Food and Drug Administration: Radiation-Emitting Products: What Are the Radiation Risks from CT? Available at Accessed December 11, 2012. Google Scholar
    • 18 : Radiation exposure in the acute and short-term management of urolithiasis at 2 academic centers. J Urol2009; 181: 668. LinkGoogle Scholar
    • 19 : 16-detector multislice CT: dosimetry estimation by TLD measurement compared with Monte Carlo simulation. Br J Radiol2004; 77: 662. Google Scholar
    • 20 : Assessment of patient effective radiation dose and associated radiogenic risk from extracorporeal shock-wave lithotripsy. Health Phys2002; 83: 847. Google Scholar
    • 21 : Determination of patient radiation dose during ureteroscopic treatment of urolithiasis using a validated model. J Urol2012; 187: 920. LinkGoogle Scholar
    • 22 : Organ-specific radiation dose rates and effective dose rates during percutaneous nephrolithotomy. J Endourol2012; 26: 439. Google Scholar
    • 23 : Effective radiation exposure in evaluation and follow-up of patients with urolithiasis. Urology2012; 79: 43. Google Scholar
    • 24 : Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med2009; 169: 2078. Google Scholar
    • 25 : Obesity triples the radiation dose of stone protocol CT. J Urol2013; 189: 2142. LinkGoogle Scholar
    • 26 : Radiation dose for body CT protocols: variability of scanners at one institution. AJR Am J Roentgenol2009; 193: 1141. Google Scholar
    • 27 : Comparative assessment of three image reconstruction techniques for image quality and radiation dose in patients undergoing abdominopelvic multidetector CT examinations. Br J Radiol2013; 86: 20120161. Google Scholar
    • 28 : Extension of RPI-adult male and female computational phantoms to obese patients and a Monte Carlo study of the effect on CT imaging dose. Phys Med Biol2012; 57: 2441. Google Scholar
    • 29 : Comparison of two types of adult phantoms in terms of organ doses from diagnostic CT procedures. Phys Med Biol2010; 55: 1441. Google Scholar
    • 30 : Validation of metal oxide semiconductor field effect transistor technology for organ dose assessment during CT: comparison with thermoluminescent dosimetry. AJR Am J Roentgenol2007; 188: 1332. Google Scholar