The average dose–area product at intravenous urography in 205 adults

The intravenous urography (IVU) is the most important and most frequently performed radiological examination in urology. This prospective study determined the dose–area product as a measurement of radiation dose in 205 adult patients undergoing IVU. Average dose–area product was 1017 cGy cm2 . An average 3.7 radiographs were obtained per patient. Tomographic views were required in only 8.8% of cases. Radiation dose is dependent not only on the number and size of the obtained radiographs, but on the physical constitution of the patient. The dose–area products measured show a clear relationship to the body weight of the patient. Introduction films used, tube voltage and the dose–area product were documented. The dose–area product as a 72 years after the first description of intravenous measure of radiation dose was determined using urography (IVU) by Volkmann in Germany [1] the Diamentor M (PTW, Freiburg/Breisgau, and Osborne in the United States [2], IVU Germany). Diamentor M uses a transparent ionizremains the most important and most frequently ation chamber at the diaphragm, specially designed performed radiological examination in urology and calibrated to measure dose–area product. The [3]. Although the introduction of diagnostic ultraDiamentor M is calibrated from the manufacturer. sound has made it possible to dispense with the Calibration is chequed monthly by a radiation routine pre-operative voiding urogram in some protection engineer. cases, there remain many indications for this radiological examination. Despite the high frequency of this examination, there is limited data concerning Results the average radiation dose associated with intraThe dose–area product as a measure of radivenous urography, particularly in adults. To help ation dose in 205 patients averaged 1017 cGy cm2 fill this void, we prospectively measured the radi(range 64–4763 cGy cm2). On the average, 3.7 ation dose in 205 patients undergoing IVU. radiographs (including the abdominal plain film) were obtained (range 2–9 films) (Table 2). Only 18 patients (8.8%) required additional tomographic Material and methods examination. In these cases, the average dose–area Between March and May 1996, a total of 205 product was 1300 cGy cm2 . As a rule, tube voltage patients underwent intravenous urography. The was set at 60 kV (range 50–70 kV). The total 120 male and 85 female patients had an average radiation dose, however, is dependent not only on age of 54.6 years (range 17–92 years). Indications for IVU are given in Table 1. On the day prior to Table 1. Indications for intravenous urography (IVU) IVU, bowel preparation was performed. Following a plain film of the abdomen, iopamidole (Solutrast Indication Absolute Relative in % 300A , Byk-Gulden, Konstanz, Germany) was applied as an intravenous contrast medium. Urolithiasis 104 51 Radiographs were obtained using the Uroskop Urologic tumour 34 16.5 Urinary obstruction 30 14.5 B X-ray unit (Siemens, Erlangen, Germany). In Haematuria 23 11 each case, the patient’s age, sex, indication for IVU, Recurrent urinary tract 5 2.5 height, body weight, number and size of X-ray infections Other 9 4.5 Received 22 July 1997 and in revised form 26 September Total 205 10