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Ultra low-dose VCUG in children using a modern flat detectorunit

  • Paediatric
  • Published:
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Abstract

Objectives

To assess dose area products (DAP) and effective doses (ED) of voiding cystourethrography (VCUG) in children using optimized protocols on a modern flat detector unit.

Methods

DAP and ED were evaluated in 651 VCUG (316 girls, median age: 2.25 years) between 2009 and 2012. DAP was analyzed in relation to patient characteristics (gender, age, presence of pathological findings) and experience of performing physician using analysis of variance. ED values were estimated using adapted conversion factors from the literature. Diagnostic image quality was validated by two experienced physicians using a 3-point scale.

Results

Median DAP/ED was 0.5 cGycm2/4.56 μSv (boys: 0.6 cGycm2/6.16 μSv; girls: 0.4 cGycm2/3.54 μSv). In 300 studies without pathologic findings DAP was 0.35 cGycm2, whereas 351 studies with pathologic findings had a median DAP of 0.7 cGycm2. No significant relationship between DAP and experience of radiologist was observed. Image validation resulted in an overall good to excellent rating.

Conclusions

DAP and ED can be markedly reduced in paediatric VCUG performed with optimized protocols on modern equipment without a noticeable decrease in diagnostic image quality.

Key points

• Voiding cystourethrography is a comprehensive examination in diagnosing vesicoureteral reflux (VUR).

• Radiation reduction is achieved in VCUG through modern equipment and optimized protocols.

• Low-dose VCUG is possible without noticeable decrease in diagnostic image quality.

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Abbreviations

VCUG:

Voiding cystourethrography

VUR:

Vesicoureteral reflux

VUS:

Voiding urosonography

RNC:

Radionuclide cystography

MR-VCUG:

Magnetic resonance voiding cystourethrography

DAP:

Dose area product

ED:

Effective dose

IRB:

Institutional review board

FD:

Flat panel detector

RIS:

Radiology information system

PACS:

Picture Archiving and Communication System

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Acknowledgments

The scientific guarantor of this publication is Jürgen F Schäfer. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, observational, performed at one institution.

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Author notes

    Authors and Affiliations

    1. Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany

      Sara Y. S. Linke, Ilias Tsiflikas, Sergios Gatidis & Jürgen F. Schäfer

    2. Department for Radiation Protection, University of Tuebingen, Auf der Morgenstelle 24, 72076, Tuebingen, Germany

      Klaus Herz

    3. Pediatric Surgery, Lucerne Cantonal Hospital, 6000, Lucerne 16, Switzerland

      Phillipp Szavay

    Authors
    1. Sara Y. S. Linke
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    Correspondence to Ilias Tsiflikas.

    Additional information

    Sara Y. S. Linke and Ilias Tsiflikas contributed equally to this work.

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    Linke, S.Y.S., Tsiflikas, I., Herz, K. et al. Ultra low-dose VCUG in children using a modern flat detectorunit. Eur Radiol 26, 1678–1685 (2016). https://doi.org/10.1007/s00330-015-3996-5

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    • DOI: https://doi.org/10.1007/s00330-015-3996-5

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