{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T15:51:30Z","timestamp":1789573890160,"version":"build-2803163510"},"reference-count":22,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction and Objective:<\/jats:title>\n                    <jats:p>Guidelines from the American Urological Association (AUA) and American College of Radiology (ACR) recommend that patients with suspected nephrolithiasis undergo low-dose CT of the kidney, ureter, and bladder (LD CT KUB) as opposed to higher dose conventional imaging. We hypothesized that even at institutions with established LD protocols, higher dose imaging is common.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>We identified four academic medical centers where LD CT KUB protocols were implemented to yield an effective dose (EDose) consistent with national guidelines. Fifty consecutive adult patients who underwent CT KUB specifically for the evaluation of nephrolithiasis were retrospectively reviewed at each site. Patient age, sex, body mass index (BMI), imaging location, and EDose (millisieverts [mSv]) were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Two hundred patients with a mean age of 54 years were identified. Forty-six patients (23%) underwent CT KUB with an EDose\n                      <jats:bold>\u2264<\/jats:bold>\n                      4 mSv, accounting for 10% to 48% of each institution's cohort. One hundred sixteen patients had a BMI &lt;30, and would have been expected to receive LD CTs by the AUA criteria for LD CT KUB. Within this subset, only 37 patients (32%) actually underwent LD CT KUB. The highest dose CT KUB at each institution resulted in an EDose of 33.8 to 44.6 mSv, exceeding the recommended exposure of LD CT KUB by 10-fold.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>At academic institutions where LD CT KUB was implemented for the evaluation of nephrolithiasis, a minority of patients with BMI &lt;30 received guideline-concordant imaging. Differences in patient BMI did not account for the variation in radiation exposure. Further research is necessary to elucidate barriers to LD CT implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/end.2022.0008","type":"journal-article","created":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T05:01:13Z","timestamp":1654146073000},"page":"1377-1381","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Multi-Institutional Variation in Performance of Low-Dose Computed Tomography for the Evaluation of Suspected Nephrolithiasis"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8182-8779","authenticated-orcid":false,"given":"Dima","family":"Raskolnikov","sequence":"first","affiliation":[{"name":"Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9423-1656","authenticated-orcid":false,"given":"David T.","family":"Tzou","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Arizona College of Medicine, Tucson, Arizona, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S.","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California San Francisco, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth K.","family":"Bechis","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California San Diego, San Diego, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas L.","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California San Francisco, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew D.","family":"Sorensen","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA."},{"name":"Division of Urology, Department of Veterans Affairs Medical Center, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marshall L.","family":"Stoller","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California San Francisco, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan D.","family":"Harper","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,10,1]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2012.03.052"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2008.10.012"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/UPJ.0000000000000148"},{"key":"e_1_3_6_5_2","unstructured":"Moreno C Beland M Goldfarb S et al. ACR Appropriateness Criteria: Acute onset flank pain\u2014Suspicion of stone disease (urolithiasis). 2015:1\u201317. Available at: https:\/\/acsearch.acr.org\/docs\/69362\/Narrative (Last accessed November17 2021)."},{"key":"e_1_3_6_6_2","doi-asserted-by":"crossref","unstructured":"National Research Council. 2006. Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2. Washington DC: The National Academies Press. https:\/\/doi.org\/10.17226\/11340.","DOI":"10.17226\/11340"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.10.031"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2019.0091"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.14131601"},{"key":"e_1_3_6_10_2","doi-asserted-by":"crossref","unstructured":"McCollough C Cody D Edyvean S et al. The measurement reporting and management of radiation dose in CT. 2008. 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