MP40-11 PROSPECTIVE ASSESSMENT OF PEDIATRIC RADIATION EXPOSURE: THE PEDIATRIC UROLOGY RADIATION SAFETY EVALUATION (PURSE) STUDY

Abstract

You have accessJournal of UrologyPediatrics: Testis & Varicoceles, Stones1 Apr 2015MP40-11 PROSPECTIVE ASSESSMENT OF PEDIATRIC RADIATION EXPOSURE: THE PEDIATRIC UROLOGY RADIATION SAFETY EVALUATION (PURSE) STUDY Anne Dudley, Moira Dwyer, Pankaj Dangle, Omaya Banihani, Heidi Stephany, Glenn Cannon, Francis Schneck, and Michael Ost Anne DudleyAnne Dudley More articles by this author , Moira DwyerMoira Dwyer More articles by this author , Pankaj DanglePankaj Dangle More articles by this author , Omaya BanihaniOmaya Banihani More articles by this author , Heidi StephanyHeidi Stephany More articles by this author , Glenn CannonGlenn Cannon More articles by this author , Francis SchneckFrancis Schneck More articles by this author , and Michael OstMichael Ost More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1193AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pediatric urologic patients often undergo procedures guided by fluoroscopy. Pediatric tissues are exquisitely sensitive to ionizing radiation, and patients are at risk for detrimental long term effects throughout their lifetimes. We sought to prospectively monitor radiation exposure in our pediatric urologic patients using single point dosimeters during fluoroscopic guided operative procedures. METHODS Pediatric patients undergoing fluoroscopic guided urologic procedures from August 2013 through October 2014 were prospectively enrolled in the IRB approved study. After obtaining informed consent from the patient's guardian, single point dosimeters were affixed to the flank of the planned procedural side with a transparent adhesive dressing. Patient demographics, procedural variables, fluoroscopic settings were recorded. Dosimetry data was recorded after analysis of single point dosimeters. RESULTS Seventy-one patients underwent 75 operative procedures including retrograde pyelogram, ureteral stent insertion ureteroscopy and percutaneous nephrolithotomy (PCNL) with dosimeter placement. Underlying diagnoses included nephrolithiasis, calyceal diverticulum, hematuria, hydronephrosis and ureteropelvic junction obstruction. Mean age was 10.8 years, and mean BMI was 21.4 (62nd percentile for age). Dosimetry data demonstrated overall cohort average dose of 210 mrad per procedure. When divided by procedure, patients received a mean dose of 2,887 mrad per PCNL, 315 mrad per ureteroscopy, 149 mrad per stent insertion and 160 mrad per retrograde pyelogram. Radiation dose was significantly higher in patients undergoing PCNL when compared with ureteroscopy, stent insertion and retrograde pyeologram. CONCLUSIONS Pediatric radiation exposure during urologic procedures is not insignificant, approaching and exceeding the recommended limit of 500 mrad/year for patients under 18 years of age. Further study characterizing pediatric urologic exposure across multiple institutions would provide context for our findings. Protocols to optimize fluoroscopic settings and minimize patient exposure continue to be refined, and should play a key role in all pediatric radiation safety initiatives. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e466-e467 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anne Dudley More articles by this author Moira Dwyer More articles by this author Pankaj Dangle More articles by this author Omaya Banihani More articles by this author Heidi Stephany More articles by this author Glenn Cannon More articles by this author Francis Schneck More articles by this author Michael Ost More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...