Sara Y S Linke1, Ilias Tsiflikas2, Klaus Herz3, Phillipp Szavay4, Sergios Gatidis1, Jürgen F Schäfer1. 1. Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany. 2. Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany. ilias.tsiflikas@med.uni-tuebingen.de. 3. Department for Radiation Protection, University of Tuebingen, Auf der Morgenstelle 24, 72076, Tuebingen, Germany. 4. Pediatric Surgery, Lucerne Cantonal Hospital, 6000, Lucerne 16, Switzerland.
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 cGycm(2)/4.56 μSv (boys: 0.6 cGycm(2)/6.16 μSv; girls: 0.4 cGycm(2)/3.54 μSv). In 300 studies without pathologic findings DAP was 0.35 cGycm(2), whereas 351 studies with pathologic findings had a median DAP of 0.7 cGycm(2). 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.
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 cGycm(2)/4.56 μSv (boys: 0.6 cGycm(2)/6.16 μSv; girls: 0.4 cGycm(2)/3.54 μSv). In 300 studies without pathologic findings DAP was 0.35 cGycm(2), whereas 351 studies with pathologic findings had a median DAP of 0.7 cGycm(2). 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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