{"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":1787821595270,"version":"build-2784847793"},"reference-count":24,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T00:00:00Z","timestamp":1732579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Computed tomography of the kidneys, ureters, and bladder (CT KUB) is essential for evaluating urinary stones but also exposes patients to significant radiation. The scanning field should be minimized to only the necessary area to limit this radiation exposure. This study aims to assess the extent of CT KUB overscanning in renal colic procedures and identify the appropriate vertebral level for starting CT KUB scans. Materials and Methods: A retrospective analysis of 299 adult patients who underwent CT KUB examinations for kidney stone assessment was performed. To assess overscanning, the number of excess slices above the pole of the highest kidney and under the pubic symphysis was measured on the axial image of each patient. To allow for potential human error, a maximum acceptable level of overscanning was set at 10%. Results: This study found that only 31% of the scans met the target of less than 10% of overscanning superior to the highest kidney and inferior to the pubic symphysis. In comparison, overscanning was present in 69% of the scans, mainly at a superior level, resulting in higher radiation exposure for patients. Conclusions: A significant number of the scans exhibited unnecessary overscanning beyond the highest kidney, prompting us to propose using the upper border of the T10 vertebral body as a potential reference point to establish the upper margin for a CT KUB scan. This study suggests using T10 and the pubic symphysis as reliable landmarks to accurately determine the scan length. Starting CT KUB scans from the T10 vertebral body to the pubic symphysis allows for imaging of the entire urinary tract, minimizing unnecessary overscanning and reducing patient irradiation.<\/jats:p>","DOI":"10.3390\/medicina60121952","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T04:20:12Z","timestamp":1732681212000},"page":"1952","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Optimizing Scan Range in Computed Tomography of Kidneys, Ureters, and Bladder: A Retrospective Study on Reducing Overscanning"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6744-641X","authenticated-orcid":false,"given":"Ali","family":"Bin Owien","sequence":"first","affiliation":[{"name":"Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia"},{"name":"Department of Radiology, King Faisal Specialist Hospital and Research Center, P.O. Box. 3354, Riyadh 12713, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2858-4759","authenticated-orcid":false,"given":"Khaled","family":"Alenazi","sequence":"additional","affiliation":[{"name":"Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9029-0368","authenticated-orcid":false,"given":"Ahmad","family":"Abanomy","sequence":"additional","affiliation":[{"name":"Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3092-4795","authenticated-orcid":false,"given":"Mansour","family":"Almanaa","sequence":"additional","affiliation":[{"name":"Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8269-2367","authenticated-orcid":false,"given":"Mohammad","family":"Alarifi","sequence":"additional","affiliation":[{"name":"Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5614-5063","authenticated-orcid":false,"given":"Haitham","family":"Alahmad","sequence":"additional","affiliation":[{"name":"Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1177\/2051415817740492","article-title":"British Association of Urological Surgeons standards for management of acute ureteric colic","volume":"11","author":"Tsiotras","year":"2017","journal-title":"J. Clin. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1016\/j.radi.2020.12.006","article-title":"CT KUB scans for renal colic: Optimisation of scan range to reduce patient radiation burden","volume":"27","author":"Ghoshal","year":"2021","journal-title":"Radiography"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1259\/bjr\/62994625","article-title":"Emergency department imaging protocol for suspected acute renal colic: Re-evaluating our service","volume":"85","author":"Patatas","year":"2012","journal-title":"Br. J. Radiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.ijsu.2012.10.007","article-title":"Rationale use of unenhanced multi-detector CT (CT KUB) in evaluation of suspected renal colic","volume":"10","author":"Nadeem","year":"2012","journal-title":"Int. J. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1007\/s00261-016-1003-5","article-title":"Alternatives to the baseline KUB for CTKUB-detected calculi: Evaluation of CT scout and average and maximum intensity projection images","volume":"42","author":"Lew","year":"2017","journal-title":"Abdom. Radiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1111\/1754-9485.12587","article-title":"Systematic review and meta-analysis of the diagnostic accuracy of low-dose computed tomography of the kidneys, ureters and bladder for urolithiasis","volume":"61","author":"Xiang","year":"2017","journal-title":"J. Med. Imaging Radiat. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1056\/NEJMoa1404446","article-title":"Ultrasonography versus computed tomography for suspected nephrolithiasis","volume":"371","author":"Aubin","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.crad.2016.10.005","article-title":"Ultra-low-dose, low-dose, and standard-dose CT of the kidney, ureters, and bladder: Is there a difference? Results from a systematic review of the literature","volume":"72","author":"Rob","year":"2017","journal-title":"Clin. Radiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1093\/rpd\/ncy164","article-title":"Suliman II: Radiation Dose Determination in Abdominal Ct Examinations of Children at Sudanese Hospitals Using Size-Specific Dose Estimates","volume":"183","author":"Bashier","year":"2019","journal-title":"Radiat. Prot. Dosim."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.ejmp.2017.12.013","article-title":"Patient-specific organ and effective dose estimates in pediatric oncology computed tomography","volume":"45","author":"Gao","year":"2018","journal-title":"Phys. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"348","DOI":"10.5173\/ceju.2015.547","article-title":"Effective radiation exposure evaluation during a one year follow-up of urolithiasis patients after extracorporeal shock wave lithotripsy","volume":"68","author":"Kaynar","year":"2015","journal-title":"Cent. Eur. J. Urol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.ajur.2019.03.007","article-title":"Percutaneous kidney stone surgery and radiation exposure: A review","volume":"7","author":"Baralo","year":"2020","journal-title":"Asian J. Urol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.radphyschem.2016.10.024","article-title":"Estimation of radiation cancer risk in CT-KUB","volume":"137","author":"Karim","year":"2017","journal-title":"Radiat. Phys. Chem."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"5821","DOI":"10.35940\/ijrte.D8635.118419","article-title":"Radiation Dose and Lifetime Risk of Cancer Incidence and Mortality in Patients Undergoing 16 Slice CT Emergency Examinations","volume":"8","author":"Tahiri","year":"2019","journal-title":"Int. J. Recent Technol. Eng. (IJRTE)"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2078","DOI":"10.1001\/archinternmed.2009.427","article-title":"Radiation Dose Associated With Common Computed Tomography Examinations and the Associated Lifetime Attributable Risk of Cancer","volume":"169","author":"Lipson","year":"2009","journal-title":"Arch. Intern. Med."},{"key":"ref_16","unstructured":"RCR (2023, October 14). Audit to Optimise CT KUB Imaging in Investigation of Renal Colic|The Royal College of Radiologists. Available online: https:\/\/www.rcr.ac.uk\/career-development\/audit-quality-improvement\/auditlive-radiology\/audit-to-optimise-ct-kub-imaging-in-investigation-of-renal-colic\/."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"20200068","DOI":"10.1259\/bjr.20200068","article-title":"It is time to think inside the (collimation) box; a quality improvement project to reduce over-scanning in CT scanning of the kidneys, ureters and bladder","volume":"93","author":"Netke","year":"2020","journal-title":"Br. J. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"20190771","DOI":"10.1259\/bjr.20190771","article-title":"Using the T11 vertebra to minimise the CT-KUB scan field","volume":"93","author":"Uldin","year":"2020","journal-title":"Br. J. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"McCollough, C., Cody, D., Edyvean, S., Geise, R., Gould, B., Keat, N., Huda, W., Judy, P., Kalender, W., and McNitt-Gray, M. (2008). The Measurement, Reporting, and Management of Radiation Dose in CT, American Association of Physicists in Medicine.","DOI":"10.37206\/97"},{"key":"ref_20","unstructured":"International Commission on Radiological Protection (2007). Recommendations of the International Commission on Radiological Protection, International Commission on Radiological Protection. ICRP Publication 103."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"256","DOI":"10.4329\/wjr.v3.i11.256","article-title":"Current status of low dose multi-detector CT in the urinary tract","volume":"3","author":"Sung","year":"2011","journal-title":"World J. Radiol."},{"key":"ref_22","unstructured":"Cavenagh, T.T.C., Seager, M.J., and Barber, J. (2017, January 1\u20135). A dynamic approach to CT KUB scanning field\u2014An audit to minimise radiation dose. Proceedings of the European Congress of Radiology, Vienna, Austria."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S12","DOI":"10.1016\/j.crad.2015.06.044","article-title":"Computed tomography (CT) kidneys, ureters and bladder (KUB)\u2014How low can you go?","volume":"70","author":"Maguire","year":"2015","journal-title":"Clin. Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1097\/RCT.0b013e3182ab5f35","article-title":"Bony landmarks on computed tomographic localizer radiographs to prescribe a reduced scan range in patients undergoing multidetector computed tomography for suspected urolithiasis","volume":"38","author":"Corwin","year":"2014","journal-title":"J. Comput. Assist. Tomogr."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/12\/1952\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:40:08Z","timestamp":1760114408000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/12\/1952"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,26]]},"references-count":24,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["medicina60121952"],"URL":"https:\/\/doi.org\/10.3390\/medicina60121952","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,26]]}}}