Radiation dose in voiding cystourethrography (VCUG) in children

Abstract

Children are more sensitive to the effects of ionizing radiation than adults. Special attention must be paid to the amount of radiation in clinical use. Most radiation induced tumors and do not become manifest until many years after exposure, so adult patients may have died of other causes before they develop. Children, because of their longer life expectancy, have a greater chance of being alive long enough for the tumor to present. Therefore, practical aspects on dose savings are the most important factors. The purpose of this study is to determine entrance skin dose (ESD) from radiographic-fluoroscopic procedures in voiding cystourethrography (VCUG) studies of pediatric patients by dose area product (DAP) recordings. Radiation doses received by 70 pediatric patients undergoing voiding cystourethrography (VCUG) procedures were determined by the transmission ionization chamber (Dose Area Product, DAP Meter, Wellhöfer Dosimetrie GmbH Bahnhofstrasse 5 D-90592 Schwarzenbruck, Germany) directly coupled to the x-ray tube window of machine (Philips Omni Diagnost Eleva) and an electrometer connected to a computer for data collection. The study revealed the radiation dose for voiding cystourethrography (VCUG) procedure and the baseline data on the entrance skin dose (ESD), dose area product (DAP) and the effective dose (E), to establish local reference dose levels in pediatric patients. The local dose reference level (DRL) at Ramathibodi Hospital, the entrance skin dose (ESD), dose area product (DAP), and effective dose (E), were determined for 0-1 years, 4 mGy, 49 cGycm2, and 0.10 mSv, for >1-5 years, 10 mGy, 176 cGycm2, and 0.37 mSv, for >5-10 years, 14 mGy, 393 cGycm2, and 0.83 mSv, for >10-15 years, 24 mGy, 708 cGycm2, and 1.49 mSv respectively. Attempts could be made to lower the radiation dose received during these procedures due to a higher risk of developing radiation-induced cancer in children.