Radiation awareness program for extracorporeal shockwave lithotripsy using Medstone lithotripters

Area of Science:

• Medical Physics
• Urology
• Radiology

Background:

• Extracorporeal shockwave lithotripsy (SWL) utilizes X-rays for stone localization, posing radiation exposure risks to patients.
• Medstone lithotripters are commonly used for SWL, necessitating an evaluation of radiation safety protocols.

Purpose of the Study:

• To assess the effectiveness of a radiation awareness program in minimizing patient radiation exposure during Medstone lithotripter procedures.
• To determine if the program impacts clinical outcomes such as stone-free rates and retreatment needs.

Main Methods:

• Radiation exposure was calculated based on estimated entrance exposure rates at 70 cm from the X-ray tube port for each SWL treatment.
• Data on stone characteristics and patient weight were collected, and results were disseminated to technologists and urologists.
• A chi-square test was employed to compare pre- and post-program radiation doses and clinical outcomes.

Main Results:

• The radiation awareness program led to a 51% average reduction in calculated radiation exposure across all patient groups.
• Statistically significant reductions in radiation exposure were observed for multiple ureteral stones (P = 0.03).
• Significant improvements were noted in stone-free rates for single renal stones (P = 0.02), retreatment rates for single ureteral stones (P < .01), and secondary procedure rates for both single renal (P = 0.01) and ureteral stones (P = 0.05).

Conclusions:

• The implemented radiation awareness program effectively reduced patient radiation exposure during Medstone lithotripsy.
• The program demonstrated a positive impact on specific clinical outcomes, suggesting its value in optimizing SWL procedures.