title: Unenhanced helical CT using increased pitch for suspected renal colic: an effective technique for radiation dose reduction?
abstract: OBJECTIVE
  To determine the accuracy and utility of unenhanced helical CT for suspected renal colic, using a pitch of either 2.5 or 3.0.
  
  
  METHODS
  59 consecutive patients underwent unenhanced helical CT. 5 mm contiguous images were obtained at a kVP of 120 and an mA of 260. Thirty-four patients were imaged at a pitch of 2.5, and 25 patients were imaged at a pitch of 3.0. Two radiologists, an attending (reader 1), and a second-year resident (reader 2), independently and retrospectively reviewed the CT images, blinded to the clinical outcome. The presence or absence of a ureteral stone was recorded and image quality was graded. A third radiologist determined accuracy for each reader. Average entrance exposure was estimated using a CT phantom at a variety of pitches.
  
  
  RESULTS
  Overall sensitivity, specificity, and accuracy for reader 1 were 91, 96, and 93%. For reader 2, they were 86, 93, and 90%. There was no significant difference in accuracy using a pitch of 3.0 compared with 2.5 for either reader. Readers 1 and 2 rated image quality at 2.5 pitch as excellent for 88 and 76% of scans, respectively; at 3.0 pitch the scans were rated by both readers as excellent for 40% and acceptable for 60%. Average entrance exposures were estimated at 461, 553. and 913 mR at pitches of 3.0, 2.5, and 1.5.
  
  
  CONCLUSIONS
  Increasing the pitch on unenhanced helical CT for suspected renal colic to 2.5 or 3.0 appears to be an effective method of reducing radiation dose. Although accuracy of the technique did not significantly change using a pitch of 3.0 in one group of patients, compared with a pitch of 2.5 in another group of patients, image quality did decrease.
authors.affiliation: Department of Radiology, Winthrop University Hospital, Mineola, Long Island, NY 11501, USA.
authors.forename: J
authors.initials: J
authors.lastname: Diel
authors.forename: S
authors.initials: S
authors.lastname: Perlmutter
authors.forename: N
authors.initials: N
authors.lastname: Venkataramanan
authors.forename: R
authors.initials: R
authors.lastname: Mueller
authors.forename: M J
authors.initials: MJ
authors.lastname: Lane
authors.forename: D S
authors.initials: DS
authors.lastname: Katz
mesh_terms: D000328:Adult; D000368:Aged; D003085:Colic / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D011835:Radiation Protection; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014514:Ureteral Calculi / Q000000981:diagnostic imaging