title: Wide Variation in Radiation Exposure During Computerized Tomography.
abstract: OBJECTIVE
  To determine the variance in computeed tomography (CT) radiation measured via dose-length product (DLP) and effective dose (ED) during stone protocol CT scans.
  
  
  METHODS
  We retrospectively examined consecutive records of patients receiving stone protocol diagnostic CT scans (n = 1793) in 2010 and 2014 in our health system. Patient age, body mass index (BMI), and gender were recorded, along with the hospital, machine model, year, DLP, and ED of each scan. Multivariate regression was performed to identify predictive factors for increased DLP. We also collected data on head (n = 837) CT scans to serve as a comparison.
  
  
  RESULTS
  For stone CT scans, mean patient age was 55.1 ± 18.4 years with no significant difference in age (P=.2557) or BMI (P=.1794) between 2010 and 2014. Gender, BMI, and machine model were independent predictors of radiation dosage (P < .0001). Within each BMI class, there was an inexplicable 6-fold variation in the ED for the same imaging test when comparing the lowest and highest CT dose patients. There was no significant change in DLP over time for stone CT scans, but head scan patients in 2014 received lower radiation doses than those in 2010 (P < .0001). Low-dose scans for renal colic (defined as <4 mSv) were underutilized. Substantial variation exists for head scan radiation doses.
  
  
  CONCLUSIONS
  Our data demonstrate large variations in diagnostic CT radiation dosage. Such differences within a single institution suggest similar trends elsewhere, warranting more stringent dosage guidelines and regulations for diagnostic CT scans within institutions.
authors.affiliation: Section of Urology, University of Chicago, Chicago, IL.
authors.forename: Andrew
authors.initials: A
authors.lastname: Cohen
authors.affiliation: Division of Urology, NorthShore University HealthSystem, Evanston, IL.
authors.forename: Katie
authors.initials: K
authors.lastname: Hughes
authors.affiliation: Division of Urology, NorthShore University HealthSystem, Evanston, IL.
authors.forename: Natalie
authors.initials: N
authors.lastname: Fahey
authors.affiliation: Division of Urology, NorthShore University HealthSystem, Evanston, IL.
authors.forename: Brandon
authors.initials: B
authors.lastname: Caldwell
authors.affiliation: Division of Urology, NorthShore University HealthSystem, Evanston, IL.
authors.forename: Chi Hsiung
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Division of Urology, NorthShore University HealthSystem, Evanston, IL. Electronic address: spark@northshore.org.
authors.forename: Sangtae
authors.initials: S
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult