Skip to main content
Top
Published in: Pediatric Radiology 6/2009

01-06-2009 | Original Article

Effective dose estimation for pediatric voiding cystourethrography using an anthropomorphic phantom set and metal oxide semiconductor field-effect transistor (MOSFET) technology

Authors: Ryan Lee, Karen E. Thomas, Bairbre L. Connolly, Michelle Falkiner, Christopher L. Gordon

Published in: Pediatric Radiology | Issue 6/2009

Login to get access

Abstract

Background

The risks associated with radiation exposure are higher in children than in adults. Therefore the use of fluoroscopy in common pediatric examinations such as voiding cystourethrography (VCUG) requires accurate determination of the associated effective dose.

Objective

To estimate effective dose for VCUG examinations performed in children younger than 10 years using anthropomorphic phantoms and metal oxide semiconductor field-effect transistor (MOSFET) dosimeters.

Materials and methods

MOSFETs were placed within four phantoms representing children ≤10 years old, at locations corresponding to radiosensitive organs, and exposed to a mock VCUG (5 min of fluoroscopy, 50 spot exposures) to minimize measurement error. Effective dose was measured and scaled to a standardized clinical VCUG (1 min fluoroscopy, 5 spot exposures) determined from patient logs. Monte Carlo simulations were performed to assess the accuracy of the measured effective dose. The dose area product (DAP) from each VCUG was compared to the effective dose.

Results

Effective doses ranged from 0.10 to 0.55 mSv, increased with age, and were higher in girls. Fluoroscopy accounted for 88–90% of the total effective dose, and spot exposures 10–12%. MOSFET-measured and simulation-derived effective doses were comparable (T > 0.12). DAP was strongly correlated with effective dose for both genders (r 2>0.97, P < 0.0001).

Conclusion

Effective doses for VCUG examinations performed in children ≤10 years of age are low but not negligible.
Literature
1.
go back to reference Schneider K, Kruger-Stollfub I, Ernst G (2001) Paediatric fluoroscopy – a survey of children’s hospitals in Europe. Pediatr Radiol 31:238–246PubMedCrossRef Schneider K, Kruger-Stollfub I, Ernst G (2001) Paediatric fluoroscopy – a survey of children’s hospitals in Europe. Pediatr Radiol 31:238–246PubMedCrossRef
2.
go back to reference ICRP (1991) 1990 Recommendations of the International Commission on Radiological Protection. Publication 60. Annals of the ICRP 21(1-3). Pergamon, Oxford ICRP (1991) 1990 Recommendations of the International Commission on Radiological Protection. Publication 60. Annals of the ICRP 21(1-3). Pergamon, Oxford
3.
go back to reference Hernandez RJ, Goodsitt MM (1996) Reduction of radiation dose in pediatric patients using pulsed fluoroscopy. AJR 167:1247–1253PubMed Hernandez RJ, Goodsitt MM (1996) Reduction of radiation dose in pediatric patients using pulsed fluoroscopy. AJR 167:1247–1253PubMed
4.
go back to reference Chapple CL, Broadhead D, Faulkner K (1995) A phantom based method for deriving typical patient doses from measurements of dose area product on populations of patients. Br J Radiol 68:1083–1086PubMed Chapple CL, Broadhead D, Faulkner K (1995) A phantom based method for deriving typical patient doses from measurements of dose area product on populations of patients. Br J Radiol 68:1083–1086PubMed
5.
go back to reference Almen A, Mattsson S (1995) The radiation dose to children from x-ray examinations of the pelvis and urinary tract. Br J Radiol 68:604–613PubMed Almen A, Mattsson S (1995) The radiation dose to children from x-ray examinations of the pelvis and urinary tract. Br J Radiol 68:604–613PubMed
6.
go back to reference Sulieman A, Theodorou K, Vlychou M et al (2007) Radiation dose measurement and risk estimation for paediatric patients undergoing micturating cystourethrography. Br J Radiol 80:731–737PubMedCrossRef Sulieman A, Theodorou K, Vlychou M et al (2007) Radiation dose measurement and risk estimation for paediatric patients undergoing micturating cystourethrography. Br J Radiol 80:731–737PubMedCrossRef
7.
go back to reference Perisinakis K, Raissaki M, Damilakis J et al (2006) Fluoroscopy-controlled voiding cystourethrography in infants and children: are the radiation risks trivial? Eur Radiol 16:846–851PubMedCrossRef Perisinakis K, Raissaki M, Damilakis J et al (2006) Fluoroscopy-controlled voiding cystourethrography in infants and children: are the radiation risks trivial? Eur Radiol 16:846–851PubMedCrossRef
8.
go back to reference Fotakis M, Molybda-Athanasopulou E, Psarrakos K et al (2003) Radiation doses to pediatric patients up to 5 years of age undergoing micturating cystourethrography examinations and its dependence on patient age: a Monte Carlo study. Br J Radiol 76:812–817PubMedCrossRef Fotakis M, Molybda-Athanasopulou E, Psarrakos K et al (2003) Radiation doses to pediatric patients up to 5 years of age undergoing micturating cystourethrography examinations and its dependence on patient age: a Monte Carlo study. Br J Radiol 76:812–817PubMedCrossRef
9.
go back to reference Jaffe TA, Gaca AM, Delaney S et al (2007) Radiation doses from small-bowel follow-through and abdominopelvic MDCT in Crohn’s disease. AJR 189:1015–1022PubMedCrossRef Jaffe TA, Gaca AM, Delaney S et al (2007) Radiation doses from small-bowel follow-through and abdominopelvic MDCT in Crohn’s disease. AJR 189:1015–1022PubMedCrossRef
10.
go back to reference Gaca AM, Jaffe TA, Delaney S et al (2008) Radiation doses from small-bowel follow-through and abdomen/pelvis MDCT in pediatric Crohn disease. Pediatr Radiol 38:285–291PubMedCrossRef Gaca AM, Jaffe TA, Delaney S et al (2008) Radiation doses from small-bowel follow-through and abdomen/pelvis MDCT in pediatric Crohn disease. Pediatr Radiol 38:285–291PubMedCrossRef
11.
go back to reference Glennie D, Connolly BL, Gordon CL (2008) Entrance skin dose measured with MOSFETs in children undergoing interventional radiography procedures. Pediatr Radiol 38:1180–1187PubMedCrossRef Glennie D, Connolly BL, Gordon CL (2008) Entrance skin dose measured with MOSFETs in children undergoing interventional radiography procedures. Pediatr Radiol 38:1180–1187PubMedCrossRef
12.
go back to reference Hurwitz LM, Yoshizumi T, Goodman P et al (2007) Effective dose determination using an anthropomorphic phantom and metal oxide semiconductor field effect transistor technology for clinical adult body multidetector computed tomography protocols. J Comput Assist Tomogr 31:544–549PubMedCrossRef Hurwitz LM, Yoshizumi T, Goodman P et al (2007) Effective dose determination using an anthropomorphic phantom and metal oxide semiconductor field effect transistor technology for clinical adult body multidetector computed tomography protocols. J Comput Assist Tomogr 31:544–549PubMedCrossRef
13.
go back to reference Yoshizumi TT, Goodman PC, Frush DP et al (2007) Validation of metal oxide semiconductor field effect transistor technology for organ dose assessment during CT: comparison with thermoluminescent dosimetry. AJR 188:1332–1336PubMedCrossRef Yoshizumi TT, Goodman PC, Frush DP et al (2007) Validation of metal oxide semiconductor field effect transistor technology for organ dose assessment during CT: comparison with thermoluminescent dosimetry. AJR 188:1332–1336PubMedCrossRef
14.
go back to reference National Research Council (2006) Health risks of exposure to low levels of ionizing radiation: BEIR VII. National Academies Press, Washington DC National Research Council (2006) Health risks of exposure to low levels of ionizing radiation: BEIR VII. National Academies Press, Washington DC
15.
go back to reference Hiorns MP, Saini A, Marsden PJ (2006) A review of current local dose-area product levels for paediatric fluoroscopy in a tertiary referral centre compared with national standards. Why are they so different? Br J Radiol 79:326–330PubMedCrossRef Hiorns MP, Saini A, Marsden PJ (2006) A review of current local dose-area product levels for paediatric fluoroscopy in a tertiary referral centre compared with national standards. Why are they so different? Br J Radiol 79:326–330PubMedCrossRef
16.
go back to reference Agrawalla S, Pearce R, Goodman TR (2004) How to perform the perfect voiding cystourethrography. Pediatr Radiol 34:114–119PubMedCrossRef Agrawalla S, Pearce R, Goodman TR (2004) How to perform the perfect voiding cystourethrography. Pediatr Radiol 34:114–119PubMedCrossRef
17.
go back to reference Schultz FW, Geleijns J, Holscher HC et al (1999) Radiation burden to paediatric patients due to micturating cystourethrography examinations in a Dutch children’s hospital. Br J Radiol 72:763–772PubMed Schultz FW, Geleijns J, Holscher HC et al (1999) Radiation burden to paediatric patients due to micturating cystourethrography examinations in a Dutch children’s hospital. Br J Radiol 72:763–772PubMed
18.
go back to reference Christy M, Eckerman KF (1987) Specific absorbed dose fractions of energy at various ages from internal photon sources. Appendix A: description of the mathematical phantoms. ORNL/TM-8381/VI. Oak Ridge National Laboratory, Oak Ridge, TN Christy M, Eckerman KF (1987) Specific absorbed dose fractions of energy at various ages from internal photon sources. Appendix A: description of the mathematical phantoms. ORNL/TM-8381/VI. Oak Ridge National Laboratory, Oak Ridge, TN
19.
go back to reference Varchena V, Gubatova DJ, Sidorin V (1993) Children’s heterogeneous phantoms and their application in roentgenology. Radiat Prot Dosim 49:77–78 Varchena V, Gubatova DJ, Sidorin V (1993) Children’s heterogeneous phantoms and their application in roentgenology. Radiat Prot Dosim 49:77–78
21.
go back to reference Servomaa A, Tapiovaara M (1998) Organ dose calculation in medical x ray examinations by the program PCXMC. Radiat Prot Dosim 80:213–219 Servomaa A, Tapiovaara M (1998) Organ dose calculation in medical x ray examinations by the program PCXMC. Radiat Prot Dosim 80:213–219
22.
go back to reference Hart D, Hillier MC, Walls BF (2002) Doses to patients from medical x-ray examinations in the UK – 2000 review. NRPB-W14. National Radiation Protection Board, Chilton, UK Hart D, Hillier MC, Walls BF (2002) Doses to patients from medical x-ray examinations in the UK – 2000 review. NRPB-W14. National Radiation Protection Board, Chilton, UK
23.
go back to reference Hart D, Hillier MC, Jones DG (2007) Doses to patients from radiographic and fluoroscopic x-ray imaging procedures in the UK – 2005 review. HPA-RPD-029. Health Protection Agency, Chilton, UK Hart D, Hillier MC, Jones DG (2007) Doses to patients from radiographic and fluoroscopic x-ray imaging procedures in the UK – 2005 review. HPA-RPD-029. Health Protection Agency, Chilton, UK
24.
go back to reference Chapple CL, Faulkner K, Lee RE et al (1992) Results of a survey of doses to paediatric patients undergoing common radiological examinations. Br J Radiol 65:225–231PubMedCrossRef Chapple CL, Faulkner K, Lee RE et al (1992) Results of a survey of doses to paediatric patients undergoing common radiological examinations. Br J Radiol 65:225–231PubMedCrossRef
25.
go back to reference Hart D, Jones DG, Wall BF (1996) Estimation of effective doses from pediatric x-ray examinations. NRPB-R279. National Radiological Protection Board, Chilton, UK Hart D, Jones DG, Wall BF (1996) Estimation of effective doses from pediatric x-ray examinations. NRPB-R279. National Radiological Protection Board, Chilton, UK
26.
go back to reference Brenner D (2002) Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative. Pediatr Radiol 32:228–231PubMedCrossRef Brenner D (2002) Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative. Pediatr Radiol 32:228–231PubMedCrossRef
27.
go back to reference Hall EJ (2002) Lessons we have learned from our children: cancer risks from diagnostic radiology. Pediatr Radiol 32:700–706PubMedCrossRef Hall EJ (2002) Lessons we have learned from our children: cancer risks from diagnostic radiology. Pediatr Radiol 32:700–706PubMedCrossRef
28.
go back to reference Brenner D, Elliston C, Hall E et al (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR 176:289–296PubMed Brenner D, Elliston C, Hall E et al (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR 176:289–296PubMed
Metadata
Title
Effective dose estimation for pediatric voiding cystourethrography using an anthropomorphic phantom set and metal oxide semiconductor field-effect transistor (MOSFET) technology
Authors
Ryan Lee
Karen E. Thomas
Bairbre L. Connolly
Michelle Falkiner
Christopher L. Gordon
Publication date
01-06-2009
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 6/2009
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-009-1161-5

Other articles of this Issue 6/2009

Pediatric Radiology 6/2009 Go to the issue

Letter to the Editor

Reply