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Related Experiment Video

Updated: May 19, 2026

Photoacoustic Cystography
09:49

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The RIVUR voiding cystourethrogram pilot study: experience with radiologic reading concordance.

Saul P Greenfield1, Myra A Carpenter, Russell W Chesney

  • 1Department of Urology, State University of New York at Buffalo School of Medicine & Biomedical Sciences, Buffalo, New York, USA. spg@buffalo.edu

The Journal of Urology
|August 23, 2012
PubMed
Summary
This summary is machine-generated.

Radiologist agreement on voiding cystourethrograms for pediatric vesicoureteral reflux was assessed. Discrepancies in grading intermediate reflux suggest current study recommendations may need reevaluation.

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Area of Science:

  • Pediatric Radiology
  • Urology
  • Medical Imaging Analysis

Background:

  • Vesicoureteral reflux (VUR) is a common condition in children.
  • Accurate grading of VUR is crucial for treatment decisions.
  • The Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial aimed to evaluate VUR treatments.

Purpose of the Study:

  • To assess inter-reader reliability in interpreting voiding cystourethrograms (VCUGs) for the RIVUR trial.
  • To identify areas of discrepancy in VUR grading and associated findings.
  • To evaluate the impact of inter-reader variability on study conclusions.

Main Methods:

  • Two reference radiologists independently reviewed digital VCUG images.
  • Discrepancies were adjudicated via teleconference to reach a final assessment.
  • Kappa statistics were used to measure agreement for various findings.

Main Results:

  • Discrepancies were noted in VUR grading for 15-16% of ureters.
  • Significant disagreement was observed in identifying paraureteral diverticulum and urethral anatomy.
  • Of 61 ureters with grade II or III reflux, 15% showed disagreement, with 78% adjudicated to the higher grade.

Conclusions:

  • Notable discrepancies exist in the assessment of intermediate-grade VUR.
  • Study findings relying on single readings or categorizing only grade III+ VUR as significant may be invalid.
  • Standardized interpretation protocols are essential for multi-center pediatric VUR trials.