Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography, Barcelona, Spain, June 2007.

We present here a few basic proposals for algorithms and procedures for imaging the paediatric genitourinary tract based on initial discussion at a paediatric uroradiology symposium and proposals of the ESUR Paediatric Uroradiologic Guidelines Subcommittee. These recommendations were developed in the light of new knowledge that might influence existing guidelines. Regional, individual and local flexibility and variability should be preserved in order to make these recommendations applicable throughout Europe. They should help standardize dedicated imaging not only in terms of a quality measure to ensure state-of-the-art patient care, but also in forming a common basis for multi-institutional research. There is an urgent need for these guidelines in order to advance our understanding of the subject and to gain evidence and improve imaging efficacy. Our session worked towards establishing an agreement on imaging indications in common paediatric urological conditions, respecting the ALARA principle, and patient safety and care, and taking into account state of the art knowledge and efficacy aspects. We started the task with a reassessment of (1) imaging in urinary tract infection in infants and children, (2) postnatal imaging in mild-to-moderate neonatal hydronephrosis, (3) how to perform voiding cystourethrography, and (4) procedural recommendations for paediatric urosonography. This list is incomplete, and future recommendations will be developed, discussed and presented at forthcoming meetings.