Radiation exposure during videourodynamic examinations in children with meningomyelocele

Abstract

Purpose In children with meningomyelocele, repeated urodynamic examinations are recommended from birth on. These are often proceeded fluoroscopicly (videourodynamic, VUD) e.g. to verify a reflux. Guidelines are vague about the frequency of required VUDs en no data exist about the effective dose, children are exposed to. To evaluate the radiation exposure in children during VUD evaluations and, based on these data, to discuss the commensurability of repeated VUD examinations in children this study was initiated. Material and methods Prospective study from a university hospital with 30 participating children between 0 and 16 years. Age, gender, dose area product, kV, mA, number of images, abdominal diameter and the field area (with affected organs) was measured and the effective dose calculated. Comparison of radiation exposure during videourodynamics with other radiologic pediatric procedures taken from the literature. Results 7 children were examinated for the first time, 23 underwent a control. No significant difference in age, abdominal diameter, time of fluoroscopy, kV and mA was found between the groups. In average, 7 fluoroscopic images were taken; significant more images were done in patients, examinated for the first time. The over all mean effective dose per child and examination was found to be 0,203 mSv. Conclusions Radiation exposure per VUD is moderate. Due to the need of repeated exposures and the vulnerability of children to irradiation, an explicit advice about the frequency of required VUD should be given in the guidelines to avoid unnecessary exposure. Generally, fluoroscopic images should be taken according to the ALARA principle.