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Minimizing radiation exposure in pediatric nephrolithiasis: The effectiveness of a low-dose computed tomography

Wyatt MacNevin1, Mareen S Kraus2, Chrissy Gamache2

  • 1Dalhousie University, Department of Urology, Halifax, Nova Scotia, Canada.

Journal of Pediatric Urology
|January 31, 2026
PubMed

Insights

A new low-dose computed tomography (CT) protocol effectively diagnoses pediatric urolithiasis, significantly reducing radiation exposure. This method maintains diagnostic accuracy for kidney stones in children, offering a safer imaging alternative.

Area of Science:

  • Pediatric Radiology
  • Medical Imaging
  • Urology

Background:

  • Pediatric nephrolithiasis diagnosis relies on ultrasonography, with CT reserved for complex cases due to radiation risks.
  • Increasing pediatric kidney stone prevalence necessitates safer imaging protocols.
  • Low-dose CT protocols for pediatric urolithiasis are scarce.

Purpose of the Study:

  • To develop and implement a novel low-dose computed tomography (CT) protocol for pediatric urolithiasis.
  • To reduce radiation exposure in pediatric patients undergoing CT for kidney stone assessment.
  • To evaluate the efficacy and safety of the new low-dose CT protocol.

Main Methods:

  • A new low-dose CT protocol was created through collaboration, literature review, and phantom studies.
  • Patients were assessed using the low-dose protocol and compared to a retrospective standard-dose cohort.
  • Radiation reduction was quantified using descriptive statistics and comparative analysis.

Main Results:

  • The low-dose protocol achieved significant radiation dose reduction: 55.5% for patients ≥45 kg (p=0.02) and 27.8% for patients <45 kg (p=0.03).
  • Diagnostic accuracy for visualizing stones seen on ultrasound was 100% (n=6).
  • The protocol identified stones in 61.5% of patients (n=16/26) with no difference in stone size compared to the standard-dose group.

Conclusions:

  • Reduced-dose CT protocols are effective for pediatric urolithiasis assessment, significantly lowering radiation exposure.
  • The developed low-dose CT protocol maintains diagnostic imaging detail for kidney stones.
  • Implementing reduced-dose CT protocols is recommended for suspected pediatric urolithiasis to minimize radiation risks.
Abstract

Keywords:
Computed tomographyPediatricsRadiationReduced-doseUrolithiasis

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