CT Scanning in the Management and ESWL of Patients with Renal Calculi

REVIEW ARTICLE

Briony Varda and Manoj Monga

Affiliation: Department of Urologic Surgery, University of Minnesota, Minneapolis, Minnesota, USA

ABSTRACT

This review article aims to summarize the value of computed tomography (CT) in determining treatment, specifically shockwave lithotripsy, for patients with renal calculi. Both CT and shockwave the lithotripsy SWL were new technologies three decades ago and have since evolved both in parallel and synergistically over time. Although initially CT was only a diagnostic tool, advances in its use and postprocessing techniques have allowed for the determination of several stone and patient characteristics that guide therapy. Over time, CT has evolved into a distinctive application as a prognostic tool for SWL. Caution must be observed, however, in over using CT due to the long-term risks of radiation exposure. Ultimately a balance must be struck between clinical utility and patient protection.

Keywords: extracorporeal shockwave lithotripsy, renal calculi, computed tomography, attenuation, Hounsfield units, skin-to-stone distance, low-dose radiation protocols

Correspondence: Manoj Monga, Department of Urologic Surgery, University of Minnesota, 420 Delaware St. SE, MMC 394, Minneapolis, MN 55455, USA. Tel: +1 612 625 7486; Fax: +1 612 624 4430; e-mail: endourol@yahoo.com