Concerns over radiation exposure touch urologists, patients

Margaret S. Pearle, MD, PhD, discusses the scope of radiation exposure and how to minimize risk from it.

Computed tomography has played a larger role in urology in recent years, the result of improvements in technology and expanding diagnostic indications. The downside is heightened radiation exposure and its associated risk to physicians and patients. In this interview, Margaret S. Pearle, MD, PhD, discusses the scope of this problem and how to minimize risk from radiation exposure. Dr. Pearle is professor of urology at the University of Texas Southwestern Medical Center, Dallas. She was interviewed by Urology Times Editorial Consultant Stephen Y. Nakada, MD, professor and chairman of urology at the University of Wisconsin, Madison.

Q: Why is there such a concern now about radiation exposure in urology?

A: There are a variety of ways of measuring radiation exposure. You can measure the actual output from the energy source, and you can also look at the amount of radiation to which a particular body part is actually exposed. The effective dose of radiation has to take into account the energy from the source as well as the actual exposure of a particular portion of the body.

Q: Can you talk about the different types of common imaging studies and how much relative radiation they have for the patient?

A: To some degree, that has been a moving target. CT scanners have improved in that the effective radiation dose has actually been reduced over time. A few years ago, a typical CT scanner probably was associated with an exposure of about 10 to 20 millisieverts, depending on whether the exposure was localized to the abdomen or to the abdomen and pelvis. The exposure from an intravenous pyelogram or a KUB can be a tenth of that. But some of the CT scanners now have actually reduced the amount of effective radiation exposure to under 10 or even under 5 millisieverts for a standard scan, such as a renal colic CT without the use of contrast.

Q: What do you recommend for our patients? For example, what should they know about imaging and radiation exposure, and what questions should they ask?

Q: What recommendations do you have for urologists and other physicians regarding radiation exposure?

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