Abstract:
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Purpose: To compare total radiation exposure and the diagnostic quality of
recorded images in voiding cystourethrograms (VCUGs) performed with a
variable-rate pulsed fluoroscopy unit (PFL) and the current standard for
pediatric radiology practice, a continuous fluoroscopy unit (CFL).
Methods and Materials: Retrospective review of VCUGs performed by staff
radiologists for common and straightforward clinical indications, from October
2001 to September 2002, yielded 150 children who were imaged with PFL or CFL.
The pulse setting for most VCUGs performed with PFL was 1.8 pulses/sec.
Children were divided into 3 groups according to fluoroscopy unit &
abdominal girth (group 1 girths 8-8.5 cm, group 2 girths 10-11 cm, group 3
girths 12-13 cm). An electronic device that monitors real-time radiographic
technique parameters was used to calculate entrance skin radiation exposure
rates and total radiation exposures. Using 5-point ordinal scales, two
radiologists scored the recorded VCUG images independently and in a blinded
fashion for anatomic conspicuity (1=highest score) and diagnostic quality
(5=highest score). Total radiation exposure, anatomic conspicuity and
diagnostic quality were expressed as median values since the variables were
non-Gaussian, with PFL and CFL compared by the Mann-Whitney U-tes
Results: The 150 children (77 females, 73 males) ranged in age from 6 days to 8
years. In all 3 groups of children, median radiation exposure was significantly
lower with PFL than CFL (all P<.001). Group 1, PFL 0.03 mR (n=29) and CFL
0.32 mR (n=41); group 2, PFL 0.03 mR (n=14) and CFL 0.51 mR (n=18); group 3,
PFL 0.04 mR (n=22) and CFL 0.45 mR (n=26). In all groups, anatomic conspicuity
was not significantly different between PFL and CFL with median scores of 1 for
both radiologists; image quality was not significantly different between PFL
and CFL with median scores of 5 for both PFL and CFL from one radiologist and 4
from the second radiologist.
Conclusion: In children undergoing VCUGs, total radiation exposure can be
reduced at least 10-fold using a PFL unit compared to a conventional CFL unit,
and the recorded images are of comparable diagnostic quality. (V.W., K.S., R.L.
received a grant from Philips Medical Systems.)
Strauss MSc, K,
Comparison of Radiation Dose and Image Quality between a Variable-Rate Pulsed Fluoroscopy Unit and a Continuous Fluoroscopy Unit in Children Undergoing Voiding Cystourethrography. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3107917.html
