Is lower-dose digital fluorography diagnostically adequate compared with higher-dose digital radiography for the diagnosis of fallopian tube stenosis?

In an effort to reduce patient radiation dose during selective fallopian tube catheterization, the diagnostic adequacy of fluoroscopic images was compared with digital radiographic images in both a phantom study and a clinical study. For the phantom study polyethylene tubes with inner diameters of 1.30, 0.95, 0.80, 0.57, and 0.45 mm were used. Randomly selected tubes with/without stenoses, recorded by digital radiographic and last-image hold fluoroscopic images, were presented to five blinded radiologists, and receiver-operating characteristic (ROC) analyses were performed. For the clinical study tubal visualization as well as detectability of stenoses and occlusions were analyzed in 14 women using a 2-way analysis of variance for nonrepeated measures. The phantom study showed no significant differences between the two imaging techniques for 0.57-mm-diameter and larger tubes; in contrast, fluoroscopic images provided significantly lower detectability of stenoses in 0.45-mm-diameter tubes (p < 0.05). The clinical study showed inferior tubal visualization and diagnostic performance for fluoroscopic images. Although fluoroscopic images have inferior diagnostic capability in detection of tubal stenoses and occlusions, these images may be adequate for documenting tubal patency with spill into the peritoneal cavity.