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Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and
Carlos Ubeda1, Patricia Miranda2, Eliseo Vano3
1Medical Technology Department, Radiological Sciences Center, Health Sciences Faculty, Tarapaca University, Arica 1000000, Chile.
Insights
This study established local diagnostic reference levels (DRLs) for pediatric interventional cardiology in Latin America. It provides crucial data for optimizing patient radiation dose in these procedures.
Area of Science:
- Medical Physics
- Radiology
- Pediatric Cardiology
Background:
- Patient radiation dose management is critical in pediatric interventional cardiology.
- Establishing diagnostic reference levels (DRLs) aids in dose optimization and quality assurance.
- This study addresses a gap in DRL data for pediatric cardiology in Latin America.
Purpose of the Study:
- To evaluate patient radiation doses in pediatric cardiology procedures.
- To propose local DRLs for various procedures and age groups in Latin America.
- To correlate patient dose values with patient weight for refined DRLs.
Main Methods:
- Collected demographic and patient dose data (age, weight, fluoroscopy time, dose-area product (DAP), cumulative dose) over three years.
- Analyzed data from 517 pediatric patients across four age groups.
- Proposed third quartile values for DAP, fluoroscopy time, and DAP/body weight ratio as local DRLs.
Main Results:
- Established DRLs for dose-area product (DAP) across different age groups, with values 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 overall sample.
- Provided specific DAP DRLs for diagnostic and therapeutic procedures within each age bracket.
Conclusions:
- The study presents the first local DRLs for pediatric interventional cardiology in Latin America.
- The proposed DRLs, including the DAP/body weight ratio, can guide dose optimization in the region.
- These findings support other Latin American hospitals in comparing and improving their patient dose values.
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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