Ionizing Radiation Exposure in Children with Vesicoureteral Reflux: Should We Be Alarmed?

Urologia Colombiana Pub Date : 2022-06-01 DOI:10.1055/s-0041-1740591

Nicolás Fernández, L. Villarraga, Julián Chavarriaga, J. Prada, Valeria Restrepo, Jaime Pérez

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Abstract

Objectives Ionizing radiation imaging is commonly used for diagnosis and follow up in children with vesicoureteral reflux (VUR). We aim to measure the effective dose (mSv) in patients with VUR. Methods We reviewed our electronic database of patients under 8-years-old with VUR. Primary endpoint was to calculate the effective radiation dose (ED). Absolute frequencies and percentages were reported for global qualitative variables. This study conducted a logistic regression model to calculate the odds ratio for radiation exposure. Analysis was performed using STATA version 14.0 (StataCorp LLC, College Station, TX, EEUU). Results A total of 140 patients were found, 97 were assessed for eligibility. We included 59 patients in the final analysis. Mean age was 20 ± 17.9 months, 66% were females. Most cases of VUR were bilateral (44%) and high grade (93.4%). The lowest number of studies per patient was two, with a minimum radiation of 5.7 mSv. The highest radiation was estimated at 20.7 mSv corresponding to a total of five studies. Logistic regression showed that highest grades of VUR and age of first UTI episode were associated with higher ED (OR, 1.7; 95% CI, 0.87-3.31), (OR 1.02; 95% CI 0.97-1.07) respectively. A mean ED for children with VUR was estimated of 5.5 ± 3 mSv/year. Conclusion In our study, the children with VUR were exposed to 5.5 mSv/year without counting the natural background radiation, which is alarming, and we believe should raise awareness worldwide in how we are unnecessarily diagnosing indolent VUR cases and following patients.

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儿童膀胱输尿管反流的电离辐射暴露：我们应该警惕吗？

目标电离辐射成像通常用于儿童膀胱输尿管反流（VUR）的诊断和随访。我们的目的是测量VUR患者的有效剂量（mSv）。方法我们回顾了8岁以下VUR患者的电子数据库。主要终点是计算有效辐射剂量（ED）。报告了全球定性变量的绝对频率和百分比。本研究采用逻辑回归模型计算辐射暴露的比值比。使用STATA 14.0版（StataCorp LLC，College Station，TX，EEUU）进行分析。后果共发现140名患者，其中97人接受了资格评估。我们将59名患者纳入最终分析。平均年龄为20±17.9个月，女性占66%。大多数VUR病例为双侧（44%）和高级别（93.4%）。每位患者的最低研究次数为两次，最低辐射量为5.7 mSv。最高辐射量估计为20.7 mSv，相当于总共五项研究。Logistic回归显示，VUR的最高级别和首次UTI发作的年龄分别与较高的ED相关（OR，1.7；95%CI，0.87-3.31），（OR 1.02；95%CI 0.97-1.07）。VUR儿童的平均ED估计为5.5±3 mSv/年。结论在我们的研究中，VUR儿童在不计算自然背景辐射的情况下暴露于5.5 mSv/年，这令人担忧，我们认为应该提高全世界对我们如何不必要地诊断惰性VUR病例和跟踪患者的认识。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologia Colombiana Medicine-Urology

CiteScore

0.30

自引率

0.00%

发文量

期刊介绍： Urología Colombiana is the serial scientific publication of the Colombian Society of Urology at intervals of three issues per year, in which the results of original research, review articles and other research designs that contribute to increase knowledge in medicine and particularly in the specialty of urology.