• Mandell GA, Eggli DF, Gilday DL, Heyman S, Leonard JC, Miller JH, Nadel HR, Piepsz A, Treves ST. Procedure guideline for radionuclide cystography in children, 3.0. Reston (VA): Society of Nuclear Medicine; 2003 Jan 25. 6 p. [7 references]

This is the current release of the guideline.

This guideline updates a previous version: Society of Nuclear Medicine. Procedure guideline for radionuclide cystography in children, 2.0. Reston (VA): Society of Nuclear Medicine; 1999 Feb. 18 p. (Society of Nuclear Medicine procedure guidelines; no. 2.0).

Background Information and Definitions

Urinary tract infection is a common problem in the pediatric population. The signs and symptoms are nonspecific, particularly in the younger child. The role of vesicoureteral reflux in the pathogenesis of pyelonephritis is incompletely understood. Approximately 40% of patients with upper urinary tract infection have vesicoureteral reflux. Urinary tract infection, unrecognized and inadequately treated, can lead to hypertension and chronic renal failure.

1. Radionuclide cystography (RNC) is a method to evaluate for vesicoureteral reflux, which results in significantly less gonadal radiation when compared with conventional radiographic technique (voiding cystourethrogram [VCUG]). In addition, radionuclide cystography has a sensitivity for detection of vesicoureteral reflux equal to that of VCUG. Radionuclide cystography does not provide the same anatomic detail as a VCUG.
2. Direct radionuclide cystography (DRC) requires catheterization of the bladder and instillation of radionuclide and fluid for maximum distension of the bladder, allowing imaging during filling, voiding and after voiding.
3. Indirect radionuclide cystography (IRC) does not require bladder catheterization but does require the intravenous injection of the radiopharmaceutical for evaluation of renal function, urine drainage, and detection of vesicoureteral reflux.

Common Indications

1. Initial evaluation of females with urinary tract infection for reflux
2. Diagnosis of familial reflux
3. Evaluation of vesicoureteral reflux after medical management
4. Assessment of the results of antireflux surgery
5. Serial evaluation of bladder dysfunction (e.g. neurogenic bladder) for reflux

Procedure

The detailed procedure recommendations in the guideline address the following areas: patient preparation; information pertinent to performing the procedure (i.e., important data that the physician should have about the patient at the time the exam is performed and interpreted); precautions; information regarding the radiopharmaceutical (i.e., ranges of administered activity, organ receiving the largest radiation dose, effective dose), image acquisition; interventions; processing; interpretation/reporting; quality control, and sources of error.

None provided

The type of evidence supporting the recommendations is not specifically stated.

• Mandell GA, Eggli DF, Gilday DL, Heyman S, Leonard JC, Miller JH, Nadel HR, Piepsz A, Treves ST. Procedure guideline for radionuclide cystography in children, 3.0. Reston (VA): Society of Nuclear Medicine; 2003 Jan 25. 6 p. [7 references]

Not applicable: The guideline was not adapted from another source.

1999 Feb (revised 2003 Jan 25)

Society of Nuclear Medicine, Inc - Medical Specialty Society

Society of Nuclear Medicine (SNM)

Task Force

Authors: Gerald A. Mandell, MD (DuPont Hospital for Children, Wilmington, DE); Douglas F. Eggli, MD (Pennsylvania State University/Milton S. Hershey Medical Center, Hershey, PA); David L. Gilday, MD (Hospital for Sick Children, Toronto, Ontario, Canada); Sydney Heyman, MD (Children's Hospital of Philadelphia, Philadelphia, PA); Joe C. Leonard, MD (Oklahoma Children's Memorial Hospital, Oklahoma City, OK); John H. Miller, MD (Children's Hospital Los Angeles, Los Angeles, CA); Helen R. Nadel, MD (Children's Hospital, British Columbia, Vancouver, Canada); Amy Piepsz, MD (CHU St. Pierre, Department of Radioisotopes, Brussels, Belgium); and S. Ted Treves, MD (Children's Hospital, Boston, MA)

Not stated

This is the current release of the guideline.

This guideline updates a previous version: Society of Nuclear Medicine. Procedure guideline for radionuclide cystography in children, 2.0. Reston (VA): Society of Nuclear Medicine; 1999 Feb. 18 p. (Society of Nuclear Medicine procedure guidelines; no. 2.0).

None available

This summary was completed by ECRI on July 20, 1999. It was verified by the guideline developer as of August 5, 1999. This NGC summary was updated by ECRI on April 14, 2005.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.