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Entrance skin dose measured with MOSFETs in children undergoing interventional radiology procedures
Diana Glennie1, Bairbre L Connolly, Christopher Gordon
1Medical and Health Physics Department, McMaster University, Hamilton, Canada.
Insights
Pediatric interventional procedures involve varying radiation doses, with some requiring close monitoring. This study measured skin entrance doses in children undergoing common procedures like PICC lines and cerebral angiography.
Area of Science:
- Medical Imaging
- Pediatric Interventional Radiology
- Radiation Dosimetry
Background:
- Interventional procedures commonly use fluoroscopy and digital subtraction angiography (DSA).
- Limited data exists on radiation doses children receive during these procedures.
Purpose of the Study:
- To quantify the skin entrance radiation dose in pediatric patients undergoing common interventional procedures.
- To establish baseline radiation dose data for pediatric interventional radiology.
Main Methods:
- MOSFET dosimeters measured skin doses in 143 children across five procedure types.
- Peak skin dose (highest recorded dose) was determined for each child.
- Doses were correlated with patient weight, fluoroscopy time, and DSA frames.
Main Results:
- Average peak skin doses varied widely: 1.4-3.9 mGy for line/tube insertions, 39.1 mGy for sclerotherapy, and 101.6-149.9 mGy for cerebral angiography.
- Effective dose estimates ranged from 0.4-3 mSv.
- Correlations between peak skin dose and procedural parameters were modest (r² < 0.4).
Conclusions:
- Pediatric interventional procedures result in a broad spectrum of radiation doses.
- Procedures with higher radiation doses necessitate careful patient monitoring and dose management.
Background:
Interventional procedures frequently employ fluoroscopy or digital subtraction angiography (DSA). Few studies have documented radiation doses received by children during these procedures.
Objective:
To measure skin entrance dose received during common pediatric interventional procedures.
Materials And Methods:
MOSFET dosimeters were placed to record skin doses in 143 children undergoing any of five procedures: 30 PICC insertions, 34 CVL/port insertions, 30 G/GJ tube insertions, 25 sclerotherapy/vascular anomaly procedures, 24 cerebral angiography procedures. The highest recorded dose (HRD) from the five MOSFET probes was assumed to be the peak skin dose per child. HRD values were averaged for children within each group and correlated with patient weight, fluoroscopy time and number of DSA frames.
Results:
Average HRD was 1.8 mGy for PICC insertions, 1.4 mGy for CVL/port insertions, 3.9 mGy for G/GJ tube insertions, 39.1 mGy for sclerotherapy/vascular anomaly procedures, and 149.9 and 101.6 mGy for frontal and lateral portions of cerebral angiography procedures. These entrance doses corresponded to effective dose estimates in the range 0.4-3 mSv. There were only modest correlations between peak skin dose and fluoroscopy time, patient weight and DSA frames (r (2)<0.4, P < 0.01).
Conclusion:
Pediatric interventional procedures are associated with a wide range of doses; those at the higher end require careful monitoring.
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