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Radiation doses in paediatric interventional cardiology procedures

Virginia Tsapaki1, Sofia Kottou, Sarantis Korniotis

  • 1Medical Physics Department, Konstantopoulio Hospital, and Medical School, University of Athens, 1 Ifaistou Street, 14569 Anixi, Athens, Greece. virginia@otenet.gr

Radiation Protection Dosimetry
|January 6, 2009
PubMed

Insights

Pediatric radiation doses from cardiac catheterization procedures, including coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA), often meet or exceed adult levels. Optimization is needed, and pediatric diagnostic reference levels (DRLs) should be established.

Area of Science:

  • Medical Physics
  • Pediatric Cardiology
  • Radiology

Background:

  • Radiation exposure in pediatric cardiac procedures is a significant concern.
  • Limited data exists on radiation doses for children undergoing coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA).

Purpose of the Study:

  • To investigate and quantify pediatric radiation doses during CA and PTCA.
  • To compare pediatric radiation doses with established adult diagnostic reference levels (DRLs).
  • To provide recommendations for dose optimization and the establishment of pediatric DRLs.

Main Methods:

  • Retrospective analysis of 40 pediatric CA and PTCA procedures.
  • Data collected included patient demographics (age, weight, height), fluoroscopy time (FT), number of images (N), and kerma-area product (KAP).
  • Comparison of collected data with adult DRLs.

Main Results:

  • Median fluoroscopy time and image counts in pediatric patients met or exceeded adult DRLs.
  • Radiation doses varied significantly with age, with newborns receiving the highest percentage of cine dose.
  • Coronary angiography (CA) median KAP: 2.1 Gy cm², PTCA median KAP: 14.7 Gy cm².
  • Median FT for CA: 4 min, N: 655; for PTCA: 12.1 min, N: 1296.

Conclusions:

  • Pediatric radiation doses from CA and PTCA require optimization.
  • The establishment of specific pediatric DRLs is crucial for radiation safety in pediatric cardiac interventions.
  • Further research into age-specific dose reduction strategies is warranted.

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