Tailored low-dose fluoroscopic voiding cystourethrography for the reevaluation of vesicoureteral reflux in girls.
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.


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.


CONCLUSIONS
Tailored low-dose fluoroscopic voiding cystourethrography is an attractive and practical alternative to the radionuclide technique in girls with proved vesicoureteral reflux.
Kleinman
P K
PK
Department of Radiology, University of Massachusetts Medical Center, Worcester 01655.
Diamond
D A
DA
Karellas
A
A
Spevak
M R
MR
Nimkin
K
K
Belanger
P
P
D002648:Child; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D010053:Ovary / Q000528:radiation effects; D011829:Radiation Dosage; D011835:Radiation Protection; D011856:Radiographic Image Enhancement; D011874:Radiometry / Q000379:methods; D014521:Urethra / Q000000981:diagnostic imaging*; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D014554:Urination; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging*