Ultra low-dose VCUG in children using a modern flat detectorunit

To assess dose area products (DAP) and effective doses (ED) of voiding cystourethrography (VCUG) in children using optimized protocols on a modern flat detector unit. DAP and ED were evaluated in 651 VCUG (316 girls, median age: 2.25 years) between 2009 and 2012. DAP was analyzed in relation to patient characteristics (gender, age, presence of pathological findings) and experience of performing physician using analysis of variance. ED values were estimated using adapted conversion factors from the literature. Diagnostic image quality was validated by two experienced physicians using a 3-point scale. Median DAP/ED was 0.5 cGycm(2)/4.56 mu Sv (boys: 0.6 cGycm(2)/6.16 mu Sv; girls: 0.4 cGycm(2)/3.54 mu Sv). In 300 studies without pathologic findings DAP was 0.35 cGycm(2), whereas 351 studies with pathologic findings had a median DAP of 0.7 cGycm(2). No significant relationship between DAP and experience of radiologist was observed. Image validation resulted in an overall good to excellent rating. DAP and ED can be markedly reduced in paediatric VCUG performed with optimized protocols on modern equipment without a noticeable decrease in diagnostic image quality. aEuro cent Voiding cystourethrography is a comprehensive examination in diagnosing vesicoureteral reflux (VUR). aEuro cent Radiation reduction is achieved in VCUG through modern equipment and optimized protocols. aEuro cent Low-dose VCUG is possible without noticeable decrease in diagnostic image quality.