Radiation exposure in vesicoureteral reflux diagnostics: a comparative study of direct radionuclide cystography and voiding cystourethrogram.
Journal
Nuclear medicine communications
ISSN: 1473-5628
Titre abrégé: Nucl Med Commun
Pays: England
ID NLM: 8201017
Informations de publication
Date de publication:
16 Oct 2024
16 Oct 2024
Historique:
medline:
16
10
2024
pubmed:
16
10
2024
entrez:
16
10
2024
Statut:
aheadofprint
Résumé
Voiding cystourethrography (VCUG) is the standard method for diagnosing vesicoureteral reflux (VUR) but has been criticized for radiation exposure. Direct radionuclide cystography (DRC) was developed to reduce this risk. We aimed to assess DRC's efficacy as a screening tool and compare its radiation burden to VCUG. We retrospectively analyzed patient records encompassing children who underwent VCUG or DRC to diagnose VUR from 2011 to 2020 at our hospital. A total of 156 children were included (median age: 0.75 years, 53.8% females). Indications included urinary tract infection in 71.2% of patients and antenatal hydronephrosis in 26.9%. DRC was performed on 122 patients (78.2%) and VCUG on 96 patients (61.5%), with solitary use in 38.5 and 21.8% of cases, respectively, and combined application in 39.7%. DRC detected VUR in 35.3% (43/122) and VCUG in 61.5% (59/96) of patients. Bladder-filling rates differed significantly between DRC (37%) and VCUG (67%) (P < 0.0001). Median radiation doses were lower in VCUG (0.023 mSv) than in DRC (0.073 mSv). For patients requiring complementary VCUG after DRC, the median radiation dose for DRC was 0.063 mSv (P < 0.0001), resulting in a total median dose of 0.098 mSv. Cost analysis revealed VCUG as more cost-effective, with an additional expenditure of approximately 345 euros per patient undergoing DRC in our cohort. DRC imposed a higher radiation burden on patients than VCUG and often necessitated follow-up VCUG for positive cases. This challenges the utility of DRC as a low-radiation alternative in VUR screening. Level 4: cohort study without a control group.
Identifiants
pubmed: 39410903
doi: 10.1097/MNM.0000000000001918
pii: 00006231-990000000-00353
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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