Pediatric Radiation Exposure and Effective Dose Reduction during Voiding Cystourethrography

Purpose: To compare radiation exposure and effective dose in children who underwent voiding cystourethrography (VCUG) performed with grid-controlled variable-rate pulsed fluoroscopy (GCPFL) with radiation exposure and effective dose in children who underwent VCUG performed with continuous fluoroscopy (CFL) and to compare these effective doses with those estimated with radionuclide cystography (RNC). Materials and Methods: Institutional review board approval was obtained, and the informed consent requirement was waived for this HIPAA-compliant retrospective study. 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, 8.08.5-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 for estimated RNC dose values. Results: GCPFL resulted in a significant reduction in total radiation exposure, which was at least eight times lower than that with CFL in all three groups (P < .001 for all). There was no significant difference in fluoroscopy time (P > .50). Effective radiation doses from GCPFL were approximately one order of magnitude lower than those from CFL but one order of magnitude higher than those from RNC. Conclusion: In children, VCUG can be performed with a GCPFL unit that delivers radiation exposures that are at least eight times lower than those delivered by a conventional CFL unit. (c) RSNA, 2008