The tailored low dose fluoroscopic voiding cystogram for familial reflux screening

Purpose: Radionuclide voiding cystography is generally advocated as a screening study to detect familial reflux. We assessed the efficacy of tailored low dose fluoroscopic voiding cystography for this purpose. Materials and Methods: We evaluated 10 boys and 10 girls 9 months to 10 years old (mean age 5 years) who were siblings of patients known to have reflux. The technique used a low dose fluoroscopic system. A tailored voiding cystographic protocol was designed to minimize gonadal radiation dose. Results: Absence of reflux was confirmed in 10 patients. Mean fluoroscopy time was 19 seconds (range 14 to 22), resulting in mean gonadal radiation exposure of less than 1.5 mrad., which is comparable to the lowest reported doses with the radionuclide technique. After reflux was demonstrated in 10 patients the study was immediately converted to a standard fluoroscopic imaging technique to define lower tract anatomy and quantitate reflux, avoiding a second study. Conclusions: Tailored low dose fluoroscopic voiding cystography appears to be a practical approach for the assessment of familial reflux.