Micturating cystourethrography (MCU) is considered to be the gold-standard method used to detect and grade vesicoureteric reflux (VUR) and show urethral and bladder abnormalities. It accounts for 30-50% of all fluoroscopic examinations in children. Therefore, it is crucial to define and optimize the radiation dose received by a child during MCU examination, taking into account that children have a higher risk of developing radiation-induced cancer than adults. This study aims to quantify and evaluate, by means of thermoluminescence dosimetry (TLD), the radiation dose to the newborn and paediatric populations undergoing MCU using fluoroscopic imaging. Evaluation of entrance surface dose (ESD), organ and surface dose to specific radiosensitive organs was carried out. Furthermore, the surface dose to the co-patient, i.e. individuals helping in the support, care and comfort of the children during the examination, was evaluated in order to estimate the level of risk. 52 patients with mean age of 0.36 years who had undergone MCU using digital fluoroscopy were studied. ESD, surface doses to thyroid, testes/ovaries and co-patients were measured with TLDs. MCU with digital equipment and fluoroscopy-captured image technique can reduce the radiation dose by approximately 50% while still obtaining the necessary diagnostic information. Radiographic exposures were made in cases of the presence of reflux or of the difficulty in evaluating a finding. The radiation surface doses to the thyroid and testes are relatively low, whereas the radiation dose to the co-patient is negligible. The risks associated with MCU for patients and co-patients are negligible. The results of this study provide baseline data to establish reference dose levels for MCU examination in very young patients.

Hysterosalpingography (HSG) is an efficient radiological examination for the evaluation of the female reproductive tract. However, it involves unavoidable irradiation to the ovaries of women in childbearing age. Therefore, radiation dose optimisation is required in order to reduce the probability of the associated risks. This study attempts to: measure patient and staff doses, estimate the effective dose and radiation risk for HSG using digital fluoroscopic images. Thirty-seven patients with infertility were examined using two digital X-ray machines. Thermoluminescence dosimeters (TLD) were used to measure entrance surface dose (ESD) for patients and staff during the procedure. The mean ESD and thyroid surface dose of the patient were 3.60 and 0.17 mGy, respectively, while the mean ESD for the staff was 0.18 mGy per procedure. The patient overall risk for cancer and hereditary effects is 24 x 10(-6), while the risk for the staff is negligible. HSG with fluoroscopic technique demonstrate improved dose characteristics, compared to the conventional radiographic-based technique, reducing the surface dose by a factor of 3, without compromising the diagnostic findings.

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