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Related Experiment Videos

The learning curve of contrast-enhanced 'microbubble' voiding urosonography-validation study.

M Velasquez1, M G Emerson2, E Diaz1

  • 1Stanford Children's Health (Lucile Packard Children's Hospital), Department of Urology, Stanford University School of Medicine, 725 Welch Road - Room 1890, Stanford, CA 94304-5913, USA.

Journal of Pediatric Urology
|May 29, 2019
PubMed
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Contrast-enhanced voiding ultrasonography (ceVUS) is a viable alternative to fluoroscopic voiding cystourethrogram (VCUG) for diagnosing pediatric vesicoureteral reflux (VUR). Despite an initial learning curve, ceVUS effectively detects reflux and eliminates radiation exposure.

Area of Science:

  • Pediatric Urology
  • Diagnostic Imaging
  • Radiology

Background:

  • Vesicoureteral reflux (VUR) is a common pediatric condition linked to urinary tract infections.
  • Diagnosis traditionally relies on fluoroscopic voiding cystourethrogram (VCUG), which involves radiation exposure.
  • Contrast-enhanced voiding ultrasonography (ceVUS) offers a radiation-free alternative, with its contrast agents recently FDA-approved for US use.

Purpose of the Study:

  • To optimize a protocol for ceVUS.
  • To compare the diagnostic performance of ceVUS against fluoroscopic VCUG.
  • To evaluate ceVUS in an academic medical center new to the technology.

Main Methods:

  • Thirty-nine pediatric patients with suspected VUR were enrolled.
  • Patients underwent both ceVUS using Lumason and fluoroscopic VCUG.
Keywords:
Contrast-enhanced voiding ultrasonographyCystourethrographyUltrasound contrastVesicoureteral refluxVoiding

Related Experiment Videos

  • Pediatric radiologists performed comparative grading of reflux on-site.

    • Main Results:

    • Reflux was detected in 16 of 39 patients (20 renal units).
    • VCUG and ceVUS showed moderate concordance (Cohen's kappa = 0.72).
    • Minor discrepancies in reflux detection and grading were observed between the two methods.

    Conclusions:

    • ceVUS is a feasible alternative to VCUG for diagnosing pediatric VUR.
    • A learning curve exists for ceVUS implementation, but technical aspects are correctable.
    • ceVUS can eliminate radiation exposure associated with VCUG, making it a valuable clinical tool.