Pediatric Radiation Exposure And Effective Dose Reduction During Voiding Cystourethrography

Main Category: Urology / Nephrology
Also Included In: Pediatrics / Children's Health;  Radiology / Nuclear Medicine
Article Date: 14 Jan 2009 - 6:00 PST

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UroToday.com - A study by Dr. Valerie L. Ward et al. compared radiation exposure and effective dose in children who underwent voiding cystourethrography (VCUG) performed with grid-controlled variable-rate pulsed fluoroscopy (GCPFL) to radiation exposure and effective dose in children who underwent VCUG performed with continuous fluoroscopy (CFL). These effective doses were compared with those estimated with radionuclide cystography (RNC).

Radiation exposure and fluoroscopy time during VCUG were reviewed in 145 children (75 girls, 70 boys; age range = 3 days to 8 years) who underwent GCPFL or CFL between 2001 and 2002. Children were grouped on the basis of the fluoroscopy unit used and their supine anteroposterior abdominal diameter (group 1 = 8.0-8.5-cm diameter; group 2 = 10-11-cm diameter; group 3 = 12-"13-cm diameter). Analysis of variance was used to compare radiation exposure and fluoroscopy time between fluoroscopy units and patient diameter groups. Effective doses were calculated and compared for both fluoroscopes and estimated RNC dose values.

The group found that GCPFL resulted in a significant reduction in total radiation exposure, which was at least 8 times lower than that with CFL in all 3 groups (P < .001 for all). There was no significant difference in fluoroscopy time (P > .50). Effective radiation doses from GCPFL were approximately 1 order of magnitude lower than those from CFL but 1 order of magnitude higher than those from RNC.

The group concluded that, in children, VCUG can be performed with a GCPFL unit that delivers radiation exposures that are at least 8 times lower than those delivered by a conventional CFL unit. We must be cognizant of the amount of radiation utilized in these studies so we do not overexpose children to high doses, especially if repeat studies are needed in the future.

Ward VL, Strauss KJ, Barnewolt CE, Zurakowski D, Venkatakrishnan V, Fahey FH, Lebowitz RL, Taylor GA
Radiology. 2008 Dec;249(3):1002-9
doi:10.1148/radiol.2492062066

Written by UroToday.com Medical Editor Pasquale Casale, MD

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