New Research: Radiation Dose in Fluoroscopic Voiding Cystourethrogram

January 7, 2019

Presented as an abstract1 at the 2018 AUA annual meeting, Rajeev Chaudhry, MD, along with division colleagues Francis Schneck, MD, and Glenn Cannon, MD, and other collaborators, discussed the findings from a recent prospective pilot study designed to measure the radiation dose in fluoroscopic voiding cystourethrogram (VCUG) in pediatric patients using a single point dosimeter.

Fluoroscopic radiation dose is always a concern, both for very young patients, or those who may need repeat scans or monitoring over time for their underlying condition, and for the physicians and OR staff members performing the procedures, particularly those operating in high-volume centers and academic teaching environments.

This new pilot study sought to measure absorbed radiation dose from a VCUG used to diagnose cases of vesicoureteral reflux. Prior to this study, accurate information on radiation exposure has not been reported in the literature.

For this study, single dosimeters were used, applied to the enrolled patient’s (n=38) sacrum. During the procedures, all patients received the same fluoroscopy settings: low dose, three pulses per second from a distance of 60 cm from the source to the skin. The smallest possible area was used on conjunction with a tightly collimated x-ray beam.

With these settings, image quality was not degraded or compromised, and the absorbed dose at the skin was low for a single VCUG procedure, showing that within these parameters and settings, and for a single procedure, VCUG is a safe diagnostic procedure for these very young patients (median age of enrolled subjects was 12.5 months). Median radiation dose at the skin was 0.33 mGy at a median fluoroscopy time of 54 seconds.

1 Use of Single Point Dosimeter to Evaluate Radiation Dose With Fluoroscopic Voiding Cystourethrogram in Pediatric Patients: A Prospective Pilot Study. Rajeev Chaudhry, Patrick J. Fox, Pankaj Dangle, Wael Abdalla, Helen Bradley, Mark Duranko, Michael Sheetz, Francis X. Schneck, Glenn M. Cannon, Michael C. Ost, Heidi A. Stephany. Abstract Presented at American Urological Association 2018 Annual Meeting.