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 vo iding cystourethrography for this purpose. SUBJECTS AND METHODS. Forty -five girls (2 years 9 months to 19 years 7 months old; mean, 7.4 year s) 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 cystourethr ographic protocol was designed to minimize ovarian radiation dose. Dig ital images were compared with standard 105-mm spot films in a similar group of 25 children. RESULTS. The tailored low dose fluoroscopic tec hnique produced diagnostically adequate images in ail patients that we re comparable in quality to standard spot films. The ovarian dose was 1.7-5.2 mrad (0.017-0.052 mCy) with a mean of 2.9 mrad (0.029 mGy). Th is compared favorably with the lowest reported doses with the radionuc lide technique. CONCLUSION. Tailored low-dose fluoroscopic voiding cys tourethrography is an attractive and practical alternative to the radi onuclide technique in girls with proved vesicoureteral reflux.