الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Unenhanced multidetector computed tomography (CT) has gained acceptance as the standard technique for evaluation of patients with flank pain. However, one major disadvantage of CT is the high radiation dose of the examination, especially when taking in consideration the fact that many of these patients need to be scanned several times during their sickness. In our study we compared unenhanced conventional CT protocols with reduced dose CT protocols in two groups of patients (LDCT group and ULDCT group) in the same setting, where the CDCT was used as the reference standard for comparison purposes. Our study suggests that low and ultralow radiation dose CT protocols are similar in detection of renal stones compared to the standard radiation protocols, while reducing patient radiation exposure by as much as 80.44% and 87.99% respectively. It can clearly detect clinically significant stones with reduction of radiation exposures to the lowest level possible for patient safety. ASIR images were far superior in improving image quality when compared with FBP images. With the ASIR approach, images were deemed of diagnostic-quality for reliable detection of urinary stones and for the identification of alternate diagnoses also. An ASIR percentage of 50% has been found to be the optimal compromise for image quality and noise distribution. Cumulative radiation exposure is an important consideration in diagnostic imaging for renal colic, particularly for recurrent-calculus formers. Thus, we support the routine use of LDCT or ULDCT with implementation of 50% ASIR to improve image quality in patients with clinical features consistent with renal colic, as supported by the EAU guidelines and other studies. Although there are still no inter-center standard protocols that can be widely used regardless of the manufacturers of IR application for the universal implementation of these protocols, we strongly believe that careful review of institutional kidney stone protocols is warranted to ensure patient safety from radiation hazards. More direct intervention may be required to see substantial and consistent dose reductions. Collaboration of not only radiology departments but also of emergency medicine and urology departments is needed to instill confidence in proper ordering of these reduced–radiation doses CT examinations.