Physician Documentation of Fluoroscopy Time in Voiding Cystourethrography Reports Correlates With Lower Fluoroscopy Times: A Surrogate Marker of Patient Radiation Exposure

OBJECTIVE: Radiation awareness has been advocated as a method of decreasing radiation exposure. For fluoroscopy, one indicator of radiation use is fluoroscopy time. We retrospectively reviewed fluoroscopy times on voiding cystourethrography (VCUG) studies performed at a major pediatric center, comparing the average fluoroscopy time of examinations with the fluoroscopy time documented in the report to the average time of those without documentation. MATERIALS AND METHODS: A database search of records for the period between June 1, 2002, and March 31, 2009, identified all VCUG examinations and their recorded fluoroscopy time in the radiology information system. Those examinations in which the fluoroscopy time was documented in the radiologist's report were also identified. Average fluoroscopy times were calculated for three groups: all VCUG examinations, examinations without the fluoroscopy time documented in the dictated report, and examinations including the fluoroscopy time in the dictated report. RESULTS: Over the 7-year study period, 10,594 VCUG examinations were performed. The average fluoroscopy time was 47 seconds for all examinations, 50 seconds for examinations without fluoroscopy time reported (n = 8484), and 32 seconds for examinations with fluoroscopy time reported (n = 1979). There was a statistically significant difference between examinations with and without fluoroscopy time reported by the radiologist (p < 0.0001). A decreasing trend in average fluoroscopy time for all VCUG examinations was identified over time (average fluoroscopy time: 65 seconds for 2002-2003 vs 29 seconds for 2008-2009). Radiologists also increasingly reported fluoroscopy time over time (fluoroscopy time reported in 1% of reports in 2002-2003 vs 82% in 2008-2009). CONCLUSION: Radiologist reporting of fluoroscopy time correlates with a decrease in fluoroscopy time, a surrogate indicator of radiation dose. Our findings suggest that the radiologist's documentation of fluoroscopy time in the report is part of a radiation awareness strategy leading to decreased fluoroscopy times.