Fluoroscopy-controlled voiding cystourethrography in infants and children: Are the radiation risks trivial?

ArticleinEuropean Radiology 16(4):846-51 · May 2006with40 Reads
DOI: 10.1007/s00330-005-0072-6 · Source: PubMed
Abstract
The purpose of this study was to determine the gonadal dose, effective dose and relevant radiogenic risks associated with pediatric patients undergoing voiding cystourethrography (VCUG). Exposure parameters were monitored in 118 consecutive children undergoing VCUG. The entrance surface dose (ESD) was determined by thermoluminescent dosimeters (TLDs). For male patients, the gonadal dose was determined by TLDs attached on the anterior scrotum. For female patients, the gonadal dose was estimated by converting ESD to the ovarian dose. ESD-to-ovarian dose conversion factors were determined by thermoluminescence dosimetry and physical anthropomorphic phantoms representing newborn and 1-, 5- and 10-year-old individuals. The effective dose was estimated by using ESD and data obtained from the literature. The mean fluoroscopy time and number of radiographs during VCUG were 0.73 min and 2.3 for female and 0.91 min and 3.0 for male pediatric patients, respectively. The gonadal dose range was 0.34-5.17 mGy in boys and 0.36-2.57 mGy in girls. The corresponding ranges of effective dosage were 0.12-1.67 mSv and 0.15-1.45 mSv. Mean radiation risks for genetic anomalies and carcinogenesis following VCUG during childhood were estimated to be up to 15 per million and 125 per million, respectively. Radiation risks associated with pediatric patients undergoing VCUG should not be disregarded if such a procedure is to be justified adequately.
    • "The difference between minimum and maximum ESAK per procedure varied up to a factor of 10. The same findings were reported in previous studies (Fefferman et al., 2009; Livingstone et al., 2008; Perisinakis et al., 2006; Sulieman et al., 2011 Sulieman et al., , 2007 Travassos et al., 2009;Ward 2006; Ward et al., 2008 ). These dose variations were attributed to the operator selection of exposure factors, patient characteristics and equipmentrelated factors. "
    Article · Mar 2016
    • "The difference between minimum and maximum ESAK per procedure varied up to a factor of 10. The same findings were reported in previous studies (Fefferman et al., 2009; Livingstone et al., 2008; Perisinakis et al., 2006; Sulieman et al., 2011 Sulieman et al., , 2007 Travassos et al., 2009;Ward 2006; Ward et al., 2008 ). These dose variations were attributed to the operator selection of exposure factors, patient characteristics and equipmentrelated factors. "
    [Show abstract] [Hide abstract] ABSTRACT: The objectives of this study were to measure the entrance surface air kerma (ESAK) and the effective doses in pediatric patients undergoing micturating cystourethrography (MCU) procedures. The ESAK was determined using calibrated thermoluminescent dosimeters (TLD- GR 200 A) in 167 pediatric patients. The patient population was categorized into three groups according to age (0–5 years (group 1), 6–10 years (group 2) and 11–15 years (group 3)). The mean ESAK ± SD and range (mGy) resulting from a MCU procedure was estimated to be 2.2±0.5 (0.8–9.2), 2.48±0.6 (0.9–8.1) and 3.90±0.6 (1.1–10.3) for group 1, 2 and 3, respectively. The mean effective dose was between 0.03 and 0.4 mSv per procedure for the pediatric population. Pediatric patients were exposed to avoidable radiation doses because no gonad shields were used.
    Full-text · Article · Mar 2016 · Open Journal of Medical Imaging
    • "ing PHILIPS and SEIMENS machines. DMSA radiopharmaceutical was administrated intravenously to the patient. Data records and information regarding patients have Voiding cystourethrography (VCUG) and ultrasound at the Department of General X-ray and Dimercaptosuccinic acid (DMSA) scintigraphy at the Department of nuclear medicine both were collected. [19] DMSA scan 1.10 -1.18 [20]"
    [Show abstract] [Hide abstract] ABSTRACT: A retrospective study for data record of 106 patients subjected to voiding cystourethrogram test(VCUG), sonography test , and dimercaptosuccinic acid (DMSA) scintigraphy take place at King Abdulaziz University, radiology department to find out the possibilities of detecting vesicoureteral reflux (VUR) in infants and children. Hydronephrosis & Renal pelvis dilatation were the highest frequency reason for VUR scan study and represent 36% of the overall cases with 53% positive finding, while Recurrent UTI frequency was 22.6% with 83% positive finding, and patients who had history of VUR comes at the third place with 15% frequency and 81 % positive finding. VUR was found in 65 of 106 children represented 61%. Male children are more likely to diagnostic with VUR than female and they represented 69% while 31% for female. Among the children with VUR, 39 had high-grade reflux (grade IV or V), while 26 had low-grade reflux (grades I, II or III). When we classified VUR into low-grade and high-grade, we found the majority of children with high-grade VUR had an abnormal DMSA and represented 77.4%, while 13 children with low-grade VUR had normal study. These studies are agreed with the present study, most children with normal DMSA scan finding had low grade reflux. In this study, 48 of 65 children (74%) the DMSA scintigraphy shows abnormal findings during the period of UTI while the VCUG scan study shows VUR in 75% of the children during the period of UTI. Comparing results of ultrasound and VCUG scan, 59% of the ultrasound findings gave the same result as VCUG in detecting the VUR in children. Then we confirm it all with the urine culture results of the same children. We found the majority of children with VUR had abnormal US finding during the period of UTI and represented 83%.
    Full-text · Article · Dec 2014
Show more