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Radiation exposure during videourodynamic testing: Is dose reduction possible using a standardized protocol?
Author(s) -
Hoffman Daniel,
Sussman Rachael D.,
Pape Dominique M.,
Smilen Scott W.,
Rosenblum Nirit,
Nitti Victor W.,
Brucker Benjamin M.
Publication year - 2020
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.24258
Subject(s) - fluoroscopy , medicine , radiation exposure , nuclear medicine , radiation dose , radiology
Aims To evaluate the impact of a protocol for standardized image capture during video urodynamics (VUD) on radiation exposure. Secondly, to categorize radiation exposure by condition warranting VUD and to identify clinical variables that correlate with increased radiation exposure. Methods One hundred fifty patients underwent VUD using our standardized protocol. All images were taken using low dose and pulsed settings. Four images are captured: one scout image, one filling image, one voiding image, and one post‐void image. If the patient is unable to void with the catheter in place, the catheter is removed and a second image is taken during an attempt at unintubated flow. If vesicoureteral reflux (VUR) is identified, an alternate protocol is entered to document parameters. The mean radiation exposure measured in dose area product (DAP), fluoroscopy time, and number of images were noted and compared with previously published fluoroscopy data collected at our institution before protocol implementation. Results The mean fluoroscopy exposure after the implementation of our protocol was 273.5 mGy/cm 2 taking 5.2 images in 4.5 seconds. Protocol implementation leads to a 51.2% reduction in radiation exposure calculated by mean DAP ( P < .0001) and a 96.5% reduction in fluoroscopy time ( P < .0001). The presence of VUR, fluoroscopy time, and body mass index (BMI) > 25 were associated with higher radiation exposure ( P < .0001). Conclusion Implementation and adherence to a standardized protocol for fluoroscopy led to a reduction in radiation exposure fluoroscopy time. The presence of VUR, fluoroscopy time, and BMI > 25 were associated with higher radiation exposure.