Urologists are concerned about excessive radiation exposure

Most urologists are concerned about radiation exposure from CT scans, and many have begun to consider more carefully the relative risks and benefits of CT and other imaging techniques.

Of note, CT scans of the abdomen and pelvis made the largest contribution to the total risk, and the mean lifetime risk for a 30-year-old individual was found to be 10 cancers per 10,000 scans (0.1%). The study findings hit home for many urologists who attended the AUA annual meeting in San Francisco, where a panel discussion touched on the data and explored the broader issue of risks associated with imaging-related radiation exposure.

We asked urologists around the country if they were concerned about these risks and what they've done to minimize them. Most, in fact, are concerned, and many have begun to consider more carefully the relative risks and benefits of CT and other imaging techniques.

Dr. Brown says the statistics were startling.

"For the first time, many of us now look at every CT scan and realize that in a middle-aged person, their chance of a subsequent future malignancy increases by 0.1%. If you polled us before, I think many of us would have guessed it was a lower risk than it really is."

Patients with stones at risk

CT is often used for following cancers, which has comprised much of Dr. Brown's career, but he says the potential for its frequent use in following stone disease can be even more critical.

"With cancers, doctors may do scans annually, even possibly semi-annually, but with stones it's not uncommon to follow stones every 4 to 6 weeks," he said. "Even before this topic came up, I spent a good bit of time educating physicians about the importance of getting KUBs rather than CTs to facilitate following stones with less radiation exposure."

In Torrance, CA, Gene A. Naftulin, MD, says recent reports about radiation exposure from imaging "shouldn't really change what we do because we've always been aware of radiation. We should order the most benign tests to get the information we need."

In practice 32 years, Dr. Naftulin says the reports at the AUA meeting did bring some new issues concerning radiation to light.

"Some of us weren't as aware that you need to know about the CT scanner being used and whether you're working with a hospital facility that has its scanner calibrated properly," he said. "These are hardware issues that I had never often considered previously.

"I got a call from the head of radiology at our hospital a few weeks ago to go over the risks presented by the scans. The hospital changed some protocols to minimize the amount of radiation exposure needed for the same test to get the same benefits."