Exposure of pediatric patients to ionizing radiation over the course of the diagnosis and treatment of vesicoureteral reflux (VUR) has been identified as a pertinent but understudied risk factor. Patients with VUR will generally undergo at least two voiding cystourethrograms (VCUG), and sometimes more for refractory cases of VUR, resulting in non-negligible total doses of ionizing radiation. Furthermore, VCUG is associated with a wide variation in radiation exposure across institutions, with variation attributable to differences in patient anatomy, imaging techniques, equipment, etc. We hypothesize that the cumulative radiation dose due to a lack of standardization and technique is not insignificant.

This study aims to answer the following set of questions:

1. Is radiation exposure in VCUG more significant than commonly assumed?

2. Is there variation in radiation exposure between different centers?

3. Is there variation in radiation exposure between patients based on their presumed diagnosis or other variables?

4. What is the cumulative radiation dose in patients under the age of 5 years who get VCUG due to VUR?

5. Are there institution-specific techniques or standards that limit radiation exposure and could be utilized across participating institutions to further limit exposure?

We have identified patients 6 months to 5 years old with UTI or VUR who have been diagnosed and/or treated at the University of Chicago Medical Center (UCMC) and had one or more VCUG exams completed. Working in collaboration with radiology and medical physics, we will analyze VCUG images, patient characteristics, and imaging equipment characteristics to determine cumulative effective dose of ionizing radiation for pediatric patients with VUR. The data collected at UCMC will be compared with data from three other medical centers in the US.

Microsoft Office

American Urologic Association (AUA) Meeting

North Central Section of AUA Meeting