The Future of Imaging in VUR: Can Ultrasound Replace VCUG?

Can ultrasound replace VCUG in children with vesicoureteral reflux?This episode argues that the better question is not simply whether reflux is present, but which child is likely to be harmed by it.We discuss VCUG, renal bladder ultrasound, contrast-enhanced voiding urosonography, Doppler, shear-wave elastography, and artificial intelligence as part of a shift from anatomical confirmation toward individualized risk prediction.The central idea: the future of VUR imaging is not just seeing reflux. It is predicting risk.Keywords: vesicoureteral reflux, VCUG, pediatric ultrasound, contrast-enhanced voiding urosonography, risk prediction.