Back to the list
Congress: ECR25
Poster Number: C-18055
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-18055
Authorblock: M. A. Rodrigues, L. Cymbron Barros, M. Silva, C. Pinto, J. P. Vieira, A. L. Faria Pinto, M. Chaves, I. C. S. P. Basto; São Miguel - Açores/PT
Disclosures:
Maria Aguiar Rodrigues: Nothing to disclose
Leonor Cymbron Barros: Nothing to disclose
Marta Silva: Nothing to disclose
Claudia Pinto: Nothing to disclose
João Pedro Vieira: Nothing to disclose
Ana Luisa Faria Pinto: Nothing to disclose
Mariana Chaves: Nothing to disclose
Isabel Cristina Silva Paiva Basto: Nothing to disclose
Keywords: Kidney, Fluoroscopy, Ultrasound, Cystography / Uretrography, Congenital, Infection
Learning objectives Radiologic imaging plays a crucial role in diagnosing and managing pediatric urinary tract infections (UTIs). The challenge lies in balancing the need for accurate diagnosis and follow-up care with concerns about unnecessary imaging, radiation exposure, and healthcare costs. A sustainable approach to follow-up care involves minimizing unnecessary imaging while still ensuring that high-risk patients receive appropriate diagnostic evaluations. This article explores the current role of radiology in pediatric UTIs, emphasizing sustainable approaches to follow-up care, updated guidelines, and recent advancements...
Read more Background Pediatric UTIs are among the most common bacterial infections in children, with an estimated prevalence of 3-5% in febrile infants [1]. Early and accurate diagnosis is essential, as untreated infections can lead to complications such as renal scarring, hypertension, and chronic kidney disease [2]. Traditionally, imaging modalities such as ultrasound (US), voiding cystourethrography (VCUG), and dimercaptosuccinic acid (DMSA) scintigraphy have been used for follow-up evaluation.However, concerns regarding overuse of imaging, exposure to ionizing radiation, and high costs have prompted a...
Read more Findings and procedure details Diagnostic Imaging Approaches Ultrasound (US): US is the first-line imaging modality due to its non-invasive nature, cost-effectiveness, and absence of ionizing radiation. It is recommended for febrile UTI cases, particularly in children under two years old or those with recurrent infections [4]. Ultrasound can detect hydronephrosis, congenital anomalies, renal abscesses, and ureteropelvic junction obstructions. However, it has limitations in detecting vesicoureteral reflux (VUR), necessitating further evaluation with other imaging modalities when clinically indicated. [fig 1] [fig 2]   Voiding Cystourethrography (VCUG): VCUG is considered...
Read more Conclusion A sustainable approach to radiologic follow-up in pediatric UTIs prioritizes selective imaging based on evidence-based guidelines. The goal is to enhance diagnostic accuracy while reducing unnecessary radiation exposure and invasive procedures. Ultrasound remains the primary modality of choice, with more invasive imaging reserved for high-risk patients based on clinical criteria.Emerging technologies, particularly AI-driven imaging analysis, offer potential to refine diagnostic workflows and improve decision-making. Future research should focus on refining risk stratification models, optimizing imaging protocols, and integrating non-invasive approaches...
Read more References American Academy of Pediatrics. Urinary Tract Infection: Clinical Practice Guideline for the Diagnosis and Management of Initial UTI in Febrile Infants and Young Children. Pediatrics. 2011;128(3):595-610. doi:10.1542/peds.2011-1330 National Institute for Health and Care Excellence (NICE). Urinary tract infection in under 16s: diagnosis and management. NICE Guideline NG224. 2022. Available at: https://www.nice.org.uk/guidance/ng224 Tekgündüz SA, Kibar AE. Imaging strategies for pediatric urinary tract infections: An update on guidelines and recent advancements. Pediatric Nephrology. 2023;38(1):67. doi:10.1007/s00467-023-06173-9 Schroeder AR, Chang PW, Shen MW, Biondi EA, Greenhow TL....
Read more
GALLERY