Abstract：
BACKGROUND: Computed tomography (CT) imaging is used for assessment of pediatric urolithiasis in cases where ultrasound is inconclusive. The utility of CT imaging must be considered alongside the potential risks of radiation exposure in this patient population due to the increased risk of cancer development. The purpose of this review is to investigate the radiation exposure associated with standard-dose and low-dose computed tomography (CT) imaging for the assessment of pediatric urolithiasis.
METHODS: A scoping literature review over a 23 year period between 2000 and 2023 was conducted of all English-language studies reporting on the use of non-contrast CT imaging for assessment of pediatric urolithiasis. Patients that were specified as pediatric with age ≤20 years at time of intervention and undergoing standard-dose or low/ultra-low-dose CT were included. Low-dose and ultra-low-dose CT were defined as a radiation dose ≤3.0 mSv and ≤1.9 mSv, respectively.
RESULTS: A total of 8121 articles were identified and after screening, 6 articles representing 309 patients were included in this scoping review. Of the articles reviewed, standard non-contrast CT radiation doses for pediatric urolithiasis evaluation ranged from 2.9 to 5.5 mSv and low-dose CT radiation dose was reported to be 1.0-2.72 mSv. Only 2 studies directly evaluated low-dose CT imaging compared to standard-dose CT imaging for pediatric urolithiasis assessment. Radiation reduction approaches did not negatively impact urolithiasis detection or characterization in 2 studies reviewed.
CONCLUSIONS: CT radiation doses for suspected or known pediatric urolithiasis are underreported and vary greatly with underutilization of low-dose/ultra-dose protocols for pediatric urolithiasis especially in comparison to the adult population. Results from this scoping review support that low-dose CTprotocols for pediatric stone disease are feasible to reduce radiation exposure.
METHODS: A scoping literature review over a 23 year period between 2000 and 2023 was conducted of all English-language studies reporting on the use of non-contrast CT imaging for assessment of pediatric urolithiasis. Patients that were specified as pediatric with age ≤20 years at time of intervention and undergoing standard-dose or low/ultra-low-dose CT were included. Low-dose and ultra-low-dose CT were defined as a radiation dose ≤3.0 mSv and ≤1.9 mSv, respectively.
RESULTS: A total of 8121 articles were identified and after screening, 6 articles representing 309 patients were included in this scoping review. Of the articles reviewed, standard non-contrast CT radiation doses for pediatric urolithiasis evaluation ranged from 2.9 to 5.5 mSv and low-dose CT radiation dose was reported to be 1.0-2.72 mSv. Only 2 studies directly evaluated low-dose CT imaging compared to standard-dose CT imaging for pediatric urolithiasis assessment. Radiation reduction approaches did not negatively impact urolithiasis detection or characterization in 2 studies reviewed.
CONCLUSIONS: CT radiation doses for suspected or known pediatric urolithiasis are underreported and vary greatly with underutilization of low-dose/ultra-dose protocols for pediatric urolithiasis especially in comparison to the adult population. Results from this scoping review support that low-dose CTprotocols for pediatric stone disease are feasible to reduce radiation exposure.
摘要：
背景：在超声不确定的情况下，计算机断层扫描（CT）成像用于评估小儿尿石症。由于癌症发展的风险增加，必须考虑CT成像的实用性以及该患者人群中辐射暴露的潜在风险。这篇评论的目的是研究与标准剂量和低剂量计算机断层扫描（CT）成像相关的辐射暴露，以评估小儿尿石症。
方法：对2000年至2023年的23年期间的所有英语研究进行了范围界定文献综述，报告使用非造影CT成像评估小儿尿石症。包括在干预时年龄≤20岁并接受标准剂量或低/超低剂量CT的儿童患者。低剂量和超低剂量CT定义为辐射剂量≤3.0mSv和≤1.9mSv，分别。
结果：共鉴定出8121篇文章，经过筛选，本范围审查包括6篇代表309名患者的文章。在审查的文章中，儿童尿石症评估的标准非对比CT辐射剂量为2.9~5.5mSv,低剂量CT辐射剂量为1.0~2.72mSv.与标准剂量CT成像相比，只有2项研究直接评估了低剂量CT成像对小儿尿石症的评估。在所审查的2项研究中，减少辐射的方法并未对尿石症的检测或表征产生负面影响。
结论：疑似或已知小儿尿石症的CT辐射剂量被低估，并且随着低剂量/超剂量方案对小儿尿石症的利用不足，差异很大，尤其是与成年人相比。这项范围审查的结果支持，针对小儿结石疾病的低剂量CT方案对于减少辐射暴露是可行的。
方法：对2000年至2023年的23年期间的所有英语研究进行了范围界定文献综述，报告使用非造影CT成像评估小儿尿石症。包括在干预时年龄≤20岁并接受标准剂量或低/超低剂量CT的儿童患者。低剂量和超低剂量CT定义为辐射剂量≤3.0mSv和≤1.9mSv，分别。
结果：共鉴定出8121篇文章，经过筛选，本范围审查包括6篇代表309名患者的文章。在审查的文章中，儿童尿石症评估的标准非对比CT辐射剂量为2.9~5.5mSv,低剂量CT辐射剂量为1.0~2.72mSv.与标准剂量CT成像相比，只有2项研究直接评估了低剂量CT成像对小儿尿石症的评估。在所审查的2项研究中，减少辐射的方法并未对尿石症的检测或表征产生负面影响。
结论：疑似或已知小儿尿石症的CT辐射剂量被低估，并且随着低剂量/超剂量方案对小儿尿石症的利用不足，差异很大，尤其是与成年人相比。这项范围审查的结果支持，针对小儿结石疾病的低剂量CT方案对于减少辐射暴露是可行的。
