Identification of ureteral stones at reduced radiation exposure: a pilot study comparing conventional versus digital low-dosage linear slot scanning (Lodox<sup>®</sup>) radiography.

Details

Serval ID
serval:BIB_BD68295DFAB1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Identification of ureteral stones at reduced radiation exposure: a pilot study comparing conventional versus digital low-dosage linear slot scanning (Lodox<sup>®</sup>) radiography.
Journal
World journal of urology
Author(s)
Fiechter S., Geissbühler E., Bähler A., Obmann V., Meierhans S., Exadaktylos A.K., Christe A., Thalmann G.N., Roth B.
ISSN
1433-8726 (Electronic)
ISSN-L
0724-4983
Publication state
Published
Issued date
04/2020
Peer-reviewed
Oui
Volume
38
Number
4
Pages
1065-1071
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Digital low-dosage, linear slot scanning radiography (Lodox <sup>®</sup> ) is an imaging modality that can emit down to one-tenth the radiation of conventional X-ray systems. We prospectively evaluated Lodox <sup>®</sup> as a diagnostic imaging modality in patients with ureterolithiasis.
Conventional kidney-ureter-bladder (KUB) X-ray and Lodox <sup>®</sup> were performed in 41 patients presenting with acute flank pain due to unilateral ureteral stone confirmed by computed tomography. KUB X-ray and Lodox <sup>®</sup> images were then reviewed by four blinded readers (urology expert/resident, radiology expert/resident). Identification rates were compared using Pearson's Chi square test. The impact of different parameters on stone identification by Lodox <sup>®</sup> was evaluated using logistic regression and generalized linear mixed models. Inter-reader agreement was tested using Cohen's kappa coefficient.
Median stone size was 5 mm (range 2-12), median stone density was 800 HU (range 200-1500). The identification rates of the urology expert were 68% for KUB X-ray and 90% for Lodox <sup>®</sup> (p = 0.014), and for all four readers 61% for KUB X-ray and 62% for Lodox <sup>®</sup> (p = 0.8). Radiation exposure for KUB X-ray and Lodox <sup>®</sup> was 0.45 mSv (SD ± 0.64) and 0.027 mSv (SD ± 0.038), respectively. Multivariable analyses showed an association between stone identification by Lodox <sup>®</sup> and stone size (p < 0.001), stone density (p = 0.005), lower body mass index (p = 0.005), and reader (p < 0.001).
The high identification rates and low radiation doses of Lodox <sup>®</sup> make it a promising imaging modality for the diagnosis of ureteral stones. Further validation in larger cohorts, including performance evaluation for renal stones, is warranted.
http://www.controlled-trails.com/ISRCTN12915426.
Keywords
Imaging, Lodox®, Radiation exposure, Urolithiasis
Pubmed
Web of science
Create date
17/06/2019 17:13
Last modification date
03/05/2020 7:02
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