Skip to main content
Log in

Pre-procedural scout radiographs are unnecessary for routine pediatric fluoroscopic examinations

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

Although practice patterns vary, scout radiographs are often routinely performed with pediatric fluoroscopic studies. However few studies have evaluated their utility in routine pediatric fluoroscopy.

Objective

To evaluate the value of scout abdomen radiographs in routine barium or water-soluble enema, upper gastrointestinal (GI) series, and voiding cystourethrogram pediatric fluoroscopic procedures.

Materials and methods

We retrospectively evaluated 723 barium or water-soluble enema, upper GI series, and voiding cystourethrogram fluoroscopic procedures performed at our institution. We assessed patient history and demographics, clinical indication for the examination, prior imaging findings and impressions, scout radiograph findings, additional findings provided by the scout radiograph that were previously unknown, and whether the scout radiograph contributed any findings that significantly changed management.

Results

We retrospectively evaluated 723 fluoroscopic studies (368 males and 355 females) in pediatric patients. Of these, 700 (96.8%) had a preliminary scout radiograph. Twenty-three (3.2%) had a same-day radiograph substituted as a scout radiograph. Preliminary scout abdomen radiographs/same-day radiographs showed no new significant findings in 719 (99.4%) studies. New but clinically insignificant findings were seen in 4 (0.6%) studies and included umbilical hernia, inguinal hernia and hip dysplasia. No findings were found on the scout radiographs that would either alter the examination performed or change management with regard to the exam.

Conclusion

Pre-procedural scout abdomen radiographs are unnecessary in routine barium and water-soluble enema, upper GI series, and voiding cystourethrogram pediatric fluoroscopic procedures and can be substituted with a spot fluoroscopic last-image hold.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Khong PL, Ringertz H, Donoghue V et al (2013) ICRP publication 121: radiological protection in paediatric diagnostic and interventional radiology. Ann ICRP 42:1–63

    Article  PubMed  Google Scholar 

  2. Strauss K, Kaste S (2006) The ALARA (as low as reasonably achievable) concept in pediatric interventional and fluoroscopic imaging: striving to keep radiation doses as low as possible during fluoroscopy of pediatric patients — a white paper executive summary. Pediatr Radiol 36:110–112

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hricak H, Brenner DJ, Adelstein SJ et al (2011) Managing radiation use in medical imaging: a multifaceted challenge. Radiology 258:889–905

    Article  PubMed  Google Scholar 

  4. Ward VL (2006) Patient dose reduction during voiding cystourethrography. Pediatr Radiol 36:168–172

    Article  PubMed  PubMed Central  Google Scholar 

  5. Mahesh M (2001) Fluoroscopy: patient radiation exposure issues. Radiographics 21:1033–1045

    Article  CAS  PubMed  Google Scholar 

  6. Lim R, Khawaja RD, Nimkin K et al (2013) Relationship between radiologist training level and fluoroscopy time for voiding cystourethrography. AJR Am J Roentgenol 200:645–651

    Article  PubMed  Google Scholar 

  7. National Research Council of the National Academies (2006) Health risks from exposure to low levels of ionizing radiation — BEIR VII. The National Academies Press, Washington, DC

    Google Scholar 

  8. Domina JG, Sanchez R, Meesa IR et al (2015) Evaluation of pediatric VCUG at an academic children’s hospital: is the radiographic scout image necessary? Pediatr Radiol 45:855–861

    Article  PubMed  Google Scholar 

  9. (2015) ACR-SPR practice parameter for the performance of contrast esophagrams and upper gastrointestinal examinations in infants and children. Res. 36. http://www.acr.org/~/media/A77716DEDE5C486EA73F2249D578FD39.pdf. Accessed 31 July 2015

  10. (2016) ACR-SPR practice parameter for the performance of pediatric fluoroscopic contrast enema examinations. Res. 9. http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/Pediatric_Contrast_Enema.pdf. Accessed 11 September 2016

  11. (2014) ACR-SPR practice parameter for the performance of voiding cystourethrography in children. Res. 13. http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/Voiding.pdf. Accessed 31 July 2015

  12. Image Gently® (2014) Pause and pulse: voiding cystourethrography (VCUG) in children — tips for dose optimization. http://imagegently.dnnstaging.com/Portals/6/Radiologists/VCUGExaminationsFINAL.pdf. Accessed 20 August 2015

  13. Darge K, Grattan-Smith JD, Riccabona M (2011) Pediatric uroradiology: state of the art. Pediatr Radiol 41:82–91

    Article  PubMed  Google Scholar 

  14. Hernanz-Schulman M, Goske MJ, Bercha IH et al (2011) Pause and pulse: ten steps that help manage radiation dose during pediatric fluoroscopy. AJR Am J Roentgenol 197:475–481

    Article  PubMed  Google Scholar 

  15. Rao AG, Simmons CE, Thacker PG et al (2016) Radiation exposure contribution of the scout abdomen radiograph in common pediatric fluoroscopic procedures. Pediatr Radiol 46:1241–1248

    Article  PubMed  Google Scholar 

  16. Darling S, Sammer M, Chapman T et al (2011) Physician documentation of fluoroscopy time in voiding cystourethrography reports correlates with lower fluoroscopy times: a surrogate marker of patient radiation exposure. AJR Am J Roentgenol 196:W777–780

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sean G. Creeden.

Ethics declarations

Conflicts of interest

None

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Creeden, S.G., Rao, A.G., Eklund, M.J. et al. Pre-procedural scout radiographs are unnecessary for routine pediatric fluoroscopic examinations. Pediatr Radiol 47, 290–293 (2017). https://doi.org/10.1007/s00247-016-3754-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-016-3754-0

Keywords

Navigation