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Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and
Insights
This study establishes initial diagnostic reference levels (DRLs) for pediatric interventional cardiology in Latin America. It proposes dose-area product (DAP) and DAP/weight ratio values to guide radiation safety for children.
Area of Science:
- Medical Physics
- Radiology
- Pediatric Cardiology
Background:
- Patient dose evaluation is crucial in pediatric interventional cardiology.
- Establishing local diagnostic reference levels (DRLs) aids in radiation safety.
- This study is the first in Latin America for pediatric interventional cardiology, supported by the International Atomic Energy Agency.
Purpose of the Study:
- To evaluate patient radiation doses in pediatric cardiology procedures.
- To propose local DRLs for various procedures and age groups.
- To correlate patient dose values with patient weight.
Main Methods:
- Collected demographic and patient dose data (age, weight, height, cine frames, fluoroscopy time, dose-area product (DAP), cumulative dose (CD)) over three years.
- Utilized third quartile values for fluoroscopy time, DAP, CD, cine frames, and DAP/body weight ratio to propose local DRLs.
- Stratified data by four age groups: <1 yr, 1 to <5 yr, 5 to <10 yr, and 10 to <16 yr.
Main Results:
- Analyzed data from 517 pediatric patients.
- Reported third quartile DAP values for diagnostic and therapeutic procedures across age groups, ranging from 1.11 to 8.68 Gy cm².
- Determined a third quartile DAP/body weight ratio of 0.17 (Gy cm²/kg) for the full sample.
Conclusions:
- Presented initial local DRLs for pediatric interventional cardiology in Latin America.
- Proposed using DAP/patient weight ratio for estimating DRLs across different patient sizes.
- Recommended these DRLs for use by other Latin American hospitals to compare and optimize patient radiation doses.
Purpose:
To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency.
Methods:
Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs.
Results:
Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for <1 yr; 213 for 1 to <5 yr; 82 for 5 to <10 yr; and 102 for 10 to <16 yr. The third quartile values obtained for DAP by diagnostic and therapeutic procedures and age range were 1.17 and 1.11 Gy cm2 for <1 yr; 1.74 and 1.90 Gy cm2 for 1 to <5 yr; 2.83 and 3.22 Gy cm2 for 5 to <10 yr; and 7.34 and 8.68 Gy cm2 for 10 to <16 yr, respectively. The third quartile value obtained for the DAP/body weight ratio for the full sample of procedures was 0.17 (Gy cm2/kg) for diagnostic and therapeutic procedures.
Conclusions:
The data presented in this paper are an initial attempt at establishing local DRLs in pediatric interventional cardiology, from a large sample of procedures for the standard age bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there may be large differences in child size. These DRLs were obtained at the largest pediatric hospital in Chile, with an active optimization program, and could be used by other hospitals in the Latin America region to compare their current patient dose values and determine whether corrective action is appropriate.
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