title: Ultra low-dose VCUG in children using a modern flat detectorunit.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  • 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.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.
authors.forename: Sara Y S
authors.initials: SY
authors.lastname: Linke
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany. ilias.tsiflikas@med.uni-tuebingen.de.
authors.forename: Ilias
authors.initials: I
authors.lastname: Tsiflikas
authors.affiliation: Department for Radiation Protection, University of Tuebingen, Auf der Morgenstelle 24, 72076, Tuebingen, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Herz
authors.affiliation: Pediatric Surgery, Lucerne Cantonal Hospital, 6000, Lucerne 16, Switzerland.
authors.forename: Phillipp
authors.initials: P
authors.lastname: Szavay
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.
authors.forename: Sergios
authors.initials: S
authors.lastname: Gatidis
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.
authors.forename: Jürgen F
authors.initials: JF
authors.lastname: Schäfer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011829:Radiation Dosage; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014554:Urination; D014567:Urography / Q000295:instrumentation* / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging*
keywords: Fluoroscopy; Pediatrics; Radiometry; Urogenital system; X-rays