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 shift towards evidence-based, sustainable imaging protocols. Recent guidelines from the American Academy of Pediatrics (AAP), National Institute for Health and Care Excellence (NICE), and the European Society for Pediatric Urology (ESPU) recommend selective imaging based on risk stratification rather than routine imaging for all children with UTIs [2,3].