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S19-9 (PP)
PROSPECTIVE EVALUATION OF RADIATION DOSE
AT SKIN ENTRANCE WITH FLUOROSCOPIC VOIDING
CYSTOURETHROGRAM IN PEDIATRIC PATIENTS
Rajeev CHAUDHRY
1
, Pankaj DANGLE
2
, Patrick FOX
1
, Wael ABDALLA
3
,
Helen BRADLEY
3
, Mark DURANKO
3
, Michael SHEETZ
3
, Glenn CANNON
1
,
Francis SCHNECK
1
, Michael OST
1
and Heidi STEPHANY
1
1) Children’s Hospital of Pittsburgh of UPMC, Pediatric Urology, Pittsburgh, USA - 2) Children’s Hospital of Pittsburgh
of UPMC, Pediatric Urology, Pittsburgh, USA - 3) Children’s Hospital of Pittsburgh of UPMC, Pediatric Radiology,
Pittsburgh, USA
PURPOSE
A voiding cystourethrogram (VCUG) is a source of ionizing radiation exposure to pediatric patients.
The actual radiation dose absorbed by the patient has not been accurately reported. We prospec-
tively measure radiation dose during VCUG using a single point dosimeter.
MATERIAL AND METHODS
Pediatric patients undergoing a VCUG were prospectively enrolled in the study. Dosimeters
(nanoDot™OSL) were affixed to the skin overlying the sacrum. Siemens™ Axiom Luminos TF
fluoroscopic machine was used, and skin-to-source distance was fixed at 60 cm, beam collimated to
the smallest area possible, low dose setting applied, and fluoroscopy pulsed at 3 frames/sec. Dose
area product determined by xray source and dose received by dosimeter (mGy) were measured
and compared.
RESULTS
Thirty-two patients were prospectively enrolled in our study with a median age of 12 months (IQR
4-48), median body mass index (BMI) of 17.2 (IQR 16.6-18.6), and female predominance (66%).
Median fluoroscopic time was 54 seconds (IQR 33-76.5). The median dose area product (mGy*m
2
)
was 6.55 (IQR 4.1-10.1) and median radiation dose absorbed at the skin entrance per dosimeter
(mGy) was 0.32 (IQR 0.11-0.58, range .01-2.9) (p=0.01). There was no correlation between ab-
sorbed dose and BMI (r = 0.12, p = 0.5), and fluoroscopy time and BMI (r = 0.23, p = 0.18). There
was a positive correlation between fluoroscopy time and absorbed dose (mGy) (r = 0.65, p < 0.001).
CONCLUSIONS
The radiation dose absorbed at skin entrance is low for a single VCUG when employing tight col-
limation, low dose settings and pulsed fluoroscopy without compromising the quality of the image.
17:26–17:40
Discussion