Risk reduction strategy for radiation exposure during percutaneous nephrolithotomy

Area of Science:

• Nephrology
• Radiology
• Medical Physics

Background:

• Nephrolithiasis patients require frequent diagnostic imaging, leading to cumulative radiation exposure.
• Percutaneous nephrolithotomy (PNL) is a common procedure for kidney stone removal that utilizes fluoroscopy, contributing to radiation dose.

Purpose of the Study:

• To assess the radiation exposure risks for patients with nephrolithiasis.
• To identify factors increasing radiation dose during PNL.
• To review methods for minimizing patient radiation exposure during PNL.

Main Methods:

• Review of existing literature on radiation exposure in nephrolithiasis patients.
• Analysis of risk factors contributing to elevated radiation doses during PNL.
• Evaluation of techniques to reduce radiation exposure, adhering to the ALARA principle.

Main Results:

• PNL with fluoroscopy can result in higher radiation doses than noncontrast CT scans of the abdomen/pelvis.
• Obesity, larger stone size, and multiple access tracts are identified risk factors for increased radiation exposure during PNL.
• Utilizing air for retrograde pyelograms and employing ultrasound are effective strategies for dose reduction.

Conclusions:

• Awareness of cumulative radiation doses in nephrolithiasis patients is crucial due to the likelihood of multiple procedures and imaging studies.
• Adoption of dose-reduction techniques during PNL is recommended to minimize patient radiation exposure.
• Minimizing radiation exposure is essential for the long-term well-being of patients undergoing treatment for nephrolithiasis.