Use of Low Dose Computed Tomography in Children with Nephrolithiasis: An Analysis from Two Tertiary Pediatric Centers

No AccessUrology PracticeClinical Research1 Nov 2023Use of Low Dose Computed Tomography in Children with Nephrolithiasis: An Analysis from Two Tertiary Pediatric Centers Ashley Pittman, Neil Paloian, Amy Y. Pan, Liyun Zhang, Andrea Moyer, Robert Medairos, Pooja Thakrar, and Jonathan Ellison Ashley PittmanAshley Pittman https://orcid.org/0000-0001-7536-873X Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin More articles by this author , Neil PaloianNeil Paloian Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author , Amy Y. PanAmy Y. Pan Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin More articles by this author , Liyun ZhangLiyun Zhang Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin More articles by this author , Andrea MoyerAndrea Moyer Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin More articles by this author , Robert MedairosRobert Medairos Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin Division of Urology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina More articles by this author , Pooja ThakrarPooja Thakrar Division of Pediatric Radiology, Department of Radiology Medical College of Wisconsin, Milwaukee, Wisconsin More articles by this author , and Jonathan EllisonJonathan Ellison *Correspondence: 999 N 92nd St Suite 330, Milwaukee, WI 53226 (telephone: 414-337-7316; e-mail address: E-mail Address: [email protected]). https://orcid.org/0000-0001-6344-2429 Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin Division of Pediatric Urology, Children’s Wisconsin, Milwaukee, Wisconsin More articles by this author View All Author Informationhttps://doi.org/10.1097/UPJ.0000000000000486AboutPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookLinked InTwitterEmail Abstract Introduction: Although ultrasound (US) is the preferred first-line imaging for pediatric nephrolithiasis, computed tomography (CT) may be necessary in cases of a non-diagnostic US or when US in not available. Utilization of dose reduction strategies in children undergoing CT for nephrolithiasis is not well described. We compared use of low dose computed tomography (LDCT) in children presenting to 2 pediatric centers. Methods: We performed a retrospective chart review of children 17 years of age presenting with suspected nephrolithiasis to 2 tertiary children’s hospitals, inclusive of those referred to these centers from non-pediatric facilities between 2013–2019. Children were included with an index CT scan from either the pediatric or referring center while those who had prior documented CT for nephrolithiasis within the study period or missing radiation dose assessment were excluded. The primary outcome was LDCT as defined as radiation dose <3 mGy. The primary comparator was pediatric versus outside referral center. Exploratory analysis evaluated other factors associated with LDCT, including radiation dosage as a continuous variable. Results: A total of 155 individuals met inclusion criteria, with 126 (81.3%) receiving standard dose and 29 (18.7%) receiving LDCT. Pediatric facilities were more likely to utilize LDCT as compared to referral centers (P < .05). Older age and higher BMI were also found to be associated with increased radiation dose exposure. Conclusion: Pediatric facilities utilized LDCT more frequently, although age and BMI may also influence imaging choices. An understanding of the factors associated with dose reduction in CT will impact future efforts to explore optimum imaging stewardship in pediatric nephrolithiasis. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.KeywordspediatricimagingNephrolithiasisMetrics Author Information Ashley Pittman Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin More articles by this author Neil Paloian Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Amy Y. Pan Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin More articles by this author Liyun Zhang Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin More articles by this author Andrea Moyer Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin More articles by this author Robert Medairos Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin Division of Urology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina More articles by this author Pooja Thakrar Division of Pediatric Radiology, Department of Radiology Medical College of Wisconsin, Milwaukee, Wisconsin More articles by this author Jonathan Ellison Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin Division of Pediatric Urology, Children’s Wisconsin, Milwaukee, Wisconsin *Correspondence: 999 N 92nd St Suite 330, Milwaukee, WI 53226 (telephone: 414-337-7316; e-mail address: E-mail Address: [email protected]). More articles by this author Expand All Advertisement PDF downloadLoading ...