{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:41:41Z","timestamp":1753879301667,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T00:00:00Z","timestamp":1667779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although voiding cystourethrogram (VCUG) is currently the gold standard in VUR evaluation, there is ionizing radiation exposure. Contrast\u2010enhanced voiding urosonography (CEVUS) uses ultrasound contrast agents to visualize the urinary tract and has been reported to be safe and effective in VUR evaluation in children. CEVUS application has yet to be specifically described in VUR evaluation in the pediatric kidney transplant population. The purpose of this study was to report the use of CEVUS and VCUG in evaluating and managing VUR in pediatric renal transplant patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review was conducted for pediatric kidney transplant patients (18\u2009years and younger) who underwent VCUG or CEVUS to assess for transplant VUR from July 2019 through June 2021. Demographic information, reason for VUR evaluation, fluoroscopy time, and postimaging complications were evaluated. Costs of imaging modalities were also considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight patients were evaluated for transplant VUR during the study period. Of the 3 patients who underwent VCUG, all 3 had VUR (median grade 3). Median fluoroscopy time was 18\u00a0s and dose\u2010area product was 18.7 uGy*m<jats:sup>2<\/jats:sup>. Of the 5 patients who underwent CEVUS, 4 had VUR (median grade 4).<\/jats:p><jats:p>There were no complications for either modality. Based on clinical and radiographic findings, patients were recommended no intervention, behavioral modification, or ureteral reimplantation. The total cost of CEVUS was $800 less than that of VCUG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CEVUS can provide an alternate means of safely evaluating VUR in kidney transplant patients with similar outcomes, potentially lower costs, and no exposure to ionizing radiation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14429","type":"journal-article","created":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T05:12:59Z","timestamp":1667884379000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Contrast\u2010enhanced voiding urosonography (<scp>CEVUS<\/scp>) as a safe alternate means of assessing vesicoureteral reflux in pediatric kidney transplant patients"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4914-4171","authenticated-orcid":false,"given":"Julie W.","family":"Cheng","sequence":"first","affiliation":[{"name":"Division of Urology Seattle Children's Hospital  Seattle Washington USA"},{"name":"Department of Urology Oregon Health and Science University  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Division of Urology Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen H. 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S.","family":"Dick","sequence":"additional","affiliation":[{"name":"Section of Transplantation Seattle Children's Hospital  Seattle Washington USA"},{"name":"Division of Transplant Surgery University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0365-4267","authenticated-orcid":false,"given":"Jodi M.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Nephrology Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark\u00a0P.","family":"Cain","sequence":"additional","affiliation":[{"name":"Division of Urology Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,7]]},"reference":[{"volume-title":"ALARA: as Defined in title 10, Section 20.1003, of the Code of Federal Regulations (10 CFR 20.1003)","year":"2012","key":"e_1_2_12_2_1"},{"key":"e_1_2_12_3_1","unstructured":"Alliance for Pediatric Radiation in Imaging.Image Gently. 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