Radiation dose and mortality risk to children undergoing therapeutic interventional cardiology

Children undergoing interventional cardiology procedures deserve special concern due to the greater radiation sensitivity of their tissues and more remaining years of life during which a radiation-induced cancer may develop.

To determine the patient radiation dose for pediatric therapeutic interventional cardiology and to estimate the patient effective dose and lifetime mortality risk to children associated with five common procedures.

Ninety children with congenital heart defects undergoing interventional therapy were enrolled in this study. Data regarding fluoroscopy and radiography time, dose-area product (DAP) and peak skin dose (PSD) for each case were measured. Patients were divided into five groups. The patient effective dose (E) was calculated using a multiplicative model of ICRP 60. The overall lifetime mortality risk was evaluated using appropriate risk coefficients.

The mean, median, standard deviation, and range of time, PSD, DAP, and E were presented for the five study groups. When these metrics were considered, there were wide variations for different cases within the same group and statistically significant differences between the five groups. The PSD correlated significantly with DAP (Pearson r = 0.70; P < 0.01), but the correlation in individual cases was poor. For all cases, the range of E was found to be between 0.44 and 66.7 mSv. The corresponding risk of lifetime mortality was 1.16 per thousand.

The current study provides overall data on the time, PSD, E, and lifetime mortality risk for pediatric therapeutic interventional cardiology. Radio frequency ablation showed the highest radiation risk.