OBJECTIVE: Radionuclide voiding cystography is generally advocated for the reevaluation of proved vesicoureteral reflux. The purpose of this study was to assess the efficacy of tailored low-dose fluoroscopic voiding cystourethrography for this purpose. SUBJECTS AND METHODS: Forty-five girls (2 years 9 months to 19 years 7 months old; mean, 7.4 years) who had proved reflux were examined with tailored low-dose voiding cystourethrography. The technique used a low-dose fluoroscopic system and a computer-based video frame grabber that produced frame-averaged digital video fluoroscopic hard copies. A tailored voiding cystourethrographic protocol was designed to minimize ovarian radiation dose. Digital images were compared with standard 105-mm spot films in a similar group of 25 children. RESULTS: The tailored low-dose fluoroscopic technique produced diagnostically adequate images in all patients that were comparable in quality to standard spot films. The ovarian dose was 1.7-5.2 mrad (0.017-0.052 mGy) with a mean of 2.9 mrad (0.029 mGy). This compared favorably with the lowest reported doses with the radionuclide technique. CONCLUSION: Tailored low-dose fluoroscopic voiding cystourethrography is an attractive and practical alternative to the radionuclide technique in girls with proved vesicoureteral reflux.
OBJECTIVE: Radionuclide voiding cystography is generally advocated for the reevaluation of proved vesicoureteral reflux. The purpose of this study was to assess the efficacy of tailored low-dose fluoroscopic voiding cystourethrography for this purpose. SUBJECTS AND METHODS: Forty-five girls (2 years 9 months to 19 years 7 months old; mean, 7.4 years) who had proved reflux were examined with tailored low-dose voiding cystourethrography. The technique used a low-dose fluoroscopic system and a computer-based video frame grabber that produced frame-averaged digital video fluoroscopic hard copies. A tailored voiding cystourethrographic protocol was designed to minimize ovarian radiation dose. Digital images were compared with standard 105-mm spot films in a similar group of 25 children. RESULTS: The tailored low-dose fluoroscopic technique produced diagnostically adequate images in all patients that were comparable in quality to standard spot films. The ovarian dose was 1.7-5.2 mrad (0.017-0.052 mGy) with a mean of 2.9 mrad (0.029 mGy). This compared favorably with the lowest reported doses with the radionuclide technique. CONCLUSION: Tailored low-dose fluoroscopic voiding cystourethrography is an attractive and practical alternative to the radionuclide technique in girls with proved vesicoureteral reflux.