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Cutting down the radiation dose on CT urography: how it is done and what results are received?

Computed tomography urography (CTU) is a very detailed and powerful method of investigating the urinary tract, but an individual approach to each patient is recommended considering also the radiation dose. This article aims to present the initial experience from the diagnosis of urinary tract diseases and congenital variants in the anatomy of the urinary system using low-kV protocols. The image quality and patient dose in CTU were compared when replacing the standard 120-kV protocol with two different low-kV protocols. Totally, 91 patients (41 women and 55 men) with mean age 56.4 were studied with three different low-dose protocols. The patients underwent an unenhanced and excretory low-dose phases and standard corticomedullary and nephrographic phases. Effective dose was reduced by more than 65 % using the 100-kV protocol and by more than 76 % with introduction of 80-kV protocol. At the same time, patient images obtained with the new low-kV protocols maintained their diagnostic quality.