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Published on: December 23, 2014
Comparison between radiation exposure levels using an image intensifier and a flat-panel detector-based system in
Roberto Miraglia1, Luigi Maruzzelli, Kelvin Cortis
1Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Via Tricomi 5, 90100, Palermo, Italy, rmiraglia@ismett.edu.
Insights
Flat-panel detector systems significantly reduce radiation exposure for pediatric central venous catheter (CVC) placement in infants. This advancement offers a safer approach for young patients requiring CVC procedures.
Area of Science:
- Pediatric radiology
- Medical imaging
- Interventional cardiology
Background:
- Ultrasound-guided central venous puncture and fluoroscopic guidance are standard for pediatric central venous catheter (CVC) placement.
- These methods optimize technical success and minimize complication rates in children.
Purpose of the Study:
- To compare radiation exposure during CVC placement in children under 10 kg.
- Procedures were performed using either an image intensifier-based angiographic system (IIDS) or a flat-panel detector-based interventional suite (FPDS).
Main Methods:
- Retrospective review of 96 image-guided CVC placements in 49 children (weighing <10 kg) between 2008 and 2013.
- Classified procedures into non-tunneled and tunneled CVC placements.
- Analyzed radiation exposure (DAP) for both systems.
Main Results:
- FPDS showed significantly lower mean radiation exposure (DAP) compared to IIDS for both non-tunneled and tunneled CVC placements.
- For non-tunneled CVC, mean DAP was 15.9 cGy·cm² with FPDS vs. 113.5 cGy·cm² with IIDS (P < 0.001).
- For tunneled CVC, mean DAP was 37.1 cGy·cm² with FPDS vs. 84.6 cGy·cm² with IIDS (P = 0.02).
Conclusions:
- Flat-panel angiographic equipment significantly reduces radiation exposure in small children undergoing image-guided CVC placement.
- FPDS offers a safer alternative for pediatric patients requiring CVC procedures.
Background:
Ultrasound-guided central venous puncture and fluoroscopic guidance during central venous catheter (CVC) positioning optimizes technical success and lowers the complication rates in children, and is therefore considered standard practice.
Objective:
The purpose of this study was to compare the radiation exposure levels recorded during CVC placement in children weighing less than 10 kg in procedures performed using an image intensifier-based angiographic system (IIDS) to those performed in a flat-panel detector-based interventional suite (FPDS).
Materials And Methods:
A retrospective review of 96 image-guided CVC placements, between January 2008 and October 2013, in 49 children weighing less than 10 kg was performed. Mean age was 8.2 ± 4.4 months (range: 1-22 months). Mean weight was 7.1 ± 2.7 kg (range: 2.5-9.8 kg). The procedures were classified into two categories: non-tunneled and tunneled CVC placement.
Results:
Thirty-five procedures were performed with the IIDS (21 non-tunneled CVC, 14 tunneled CVC); 61 procedures were performed with the FPDS (47 non-tunneled CVC, 14 tunneled CVC). For non-tunneled CVC, mean DAP was 113.5 ± 126.7 cGy cm(2) with the IIDS and 15.9 ± 44.6 cGy · cm(2) with the FPDS (P < 0.001). For tunneled CVC, mean DAP was 84.6 ± 81.2 cGy · cm(2) with the IIDS and 37.1 ± 33.5 cGy cm(2) with the FPDS (P = 0.02).
Conclusion:
The use of flat-panel angiographic equipment reduces radiation exposure in small children undergoing image-guided CVC placement.
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