Is lower-dose digital fluorography diagnostically adequate compared with higher-dose digital radiography for the diagnosis of fallopian tube stenosis?

Purpose: In an effort to reduce patient radiation dose during selective fal lopian tube catheterization, the diagnostic adequacy of fluoroscopic images was compared with digital radiographic images in both a phantom study and a clinical study. Methods: For the phantom study polyethylene tubes with inner diameters of 1 .30, 0.95, 0.80, 0.57, and 0.45 mm were used. Randomly selected tubes with/ without stenoses, recorded by digital radiographic and last-image hold: flu oroscopic images, were presented to five blinded radiologists, and receiver -operating characteristic (ROC) analyses were performed. For the clinical s tudy tubal visualization as well as detectability of stenoses and occlusion s were analyzed in 14 women using a 2-way analysis of variance for nonrepea ted measures. Results: The phantom study showed no significant differences between the tw o imaging techniques for 0.57-mm-diameter and larger tubes; in contrast, fl uoroscopic images provided significantly lower detectability of stenoses in 0.45-mm-diameter tubes (p < 0.05). The clinical study showed inferior tuba l visualization and diagnostic performance for fluoroscopic images. Conclusions: Although fluoroscopic images have inferior diagnostic capabili ty in detection of tubal stenoses and occlusions, these images may be adequ ate for documenting tubal patency with spill into the peritoneal cavity.