{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:06:35Z","timestamp":1787821595266,"version":"build-2784847793"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"1110","license":[{"start":{"date-parts":[[2020,3,25]],"date-time":"2020-03-25T00:00:00Z","timestamp":1585094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives:<\/jats:title>\n                  <jats:p>Computed tomography scans of the kidney, ureters, and bladder (CT-KUB) are crucial in investigating urinary calculi but impart a substantial radiation doses. Radiation can be limited by minimising the scanning field to the necessary area (i.e. from the kidneys to urethra). Before auditing, the superior limit of CT-KUB scans had not been formally clarified at our trust. Consistently ensuring the upper limit of scans is at or below T10 has been shown to be a viable method of performing CT-KUB scans. This study aimed to assess the overscan length of CT-KUB investigations and modify practice accordingly to minimise it. There were two standards that were set for CT-KUB scanning. First, the mean percentage overscan length (i.e. percentage of the scan above the kidneys) should be &amp;lt;15%. Second, all scans should include the superior borders of both kidneys.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>90 consecutive CT-KUB scans for ureteric calculus were retrospectively investigated using IMPAX software in the first phase of data collection. After these data were analysed, a newly devised protocol using T11 as the superior scan limit was delivered to radiographers in the department. and 105 in the second phase (re-audit). The analysis parameters were: percentage overscan length, distance between diaphragm and upper border of kidneys, vertebral level at which the scan commenced, and whether both kidneys were fully included.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>In the first phase, overscan of &amp;gt;15% was present in 94.4% of scans. The mean percentage overscan length was 28.2%. The superior vertebral limit of 59% of scans was at T10 or below and a lower superior vertebral limit correlated with decreasing overscan. 99% of scans fully included both kidneys. In the second phase (3 months later), the mean overscan percentage reduced to 10.6% (standard deviation = 4.4%). Excessive overscan affected 35.2% of scans. The superior vertebral limit of 8% of scans was at T10 or below. 100% of scans fully included both kidneys.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>Excessive overscanning was due to inconsistent technique in capturing CT-KUB scans. Before this audit, the superior limit of CT-KUB scans had not been formally clarified at our trust. By successfully standardising the process with a reproducible method, the overscan target was comfortably met. Therefore, patient dose was minimised without compromising scan quality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge:<\/jats:title>\n                  <jats:p>This audit has successfully shown a feasible standardised protocol for CT-KUB investigations which can be used to minimise overscanning of patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1259\/bjr.20190771","type":"journal-article","created":{"date-parts":[[2020,3,25]],"date-time":"2020-03-25T18:26:57Z","timestamp":1585160817000},"source":"Crossref","is-referenced-by-count":13,"title":["Using the T11 vertebra to minimise the CT-KUB scan field"],"prefix":"10.1093","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7060-211X","authenticated-orcid":false,"given":"Hasaam","family":"Uldin","sequence":"first","affiliation":[{"name":"Heartlands, Good Hope, and Solihull Hospitals, University Hospitals Birmingham NHS Foundation Trust , Birmingham , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunan","family":"McGlynn","sequence":"additional","affiliation":[{"name":"Heartlands, Good Hope, and Solihull Hospitals, University Hospitals Birmingham NHS Foundation Trust , Birmingham , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Cleasby","sequence":"additional","affiliation":[{"name":"Heartlands, Good Hope, and Solihull Hospitals, University Hospitals Birmingham NHS Foundation Trust , Birmingham , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,3,25]]},"reference":[{"key":"2024050215263089500_b1","volume-title":"Renal and ureteric stones: assessment and management","author":"National Guideline Centre (UK)","year":"2019"},{"key":"2024050215263089500_b2","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1148\/radiol.12112470","article-title":"Radiation 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Clinical Radiology"},{"key":"2024050215263089500_b18","article-title":"A dynamic approach to CT KUB scanning field - an audit to minimise radiation dose","volume":"2017","author":"Cavenagh","year":"2017","journal-title":"European Congress of Radiology"},{"key":"2024050215263089500_b19","doi-asserted-by":"crossref","first-page":"42","DOI":"10.14444\/2042","article-title":"A review of symptomatic lumbosacral transitional vertebrae: Bertolotti's syndrome","volume":"9","author":"Jancuska","year":"2015","journal-title":"Int J Spine Surg"},{"key":"2024050215263089500_b20","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1148\/radiol.11081511","article-title":"Effect of spinal segment variants on numbering vertebral levels at lumbar MR imaging","volume":"259","author":"Carrino","year":"2011","journal-title":"Radiology"}],"container-title":["The British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/93\/1110\/20190771\/57376484\/bjr.20190771.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/93\/1110\/20190771\/57376484\/bjr.20190771.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T16:06:11Z","timestamp":1714665971000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/article\/doi\/10.1259\/bjr.20190771\/7452111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,25]]},"references-count":20,"journal-issue":{"issue":"1110","published-online":{"date-parts":[[2020,3,25]]},"published-print":{"date-parts":[[2020,5,1]]}},"URL":"https:\/\/doi.org\/10.1259\/bjr.20190771","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"value":"0007-1285","type":"print"},{"value":"1748-880X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,5,1]]},"published":{"date-parts":[[2020,3,25]]},"article-number":"20190771"}}