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Towards the definition of Institutional diagnostic reference levels in paediatric interventional cardiology

S Kottou1, N Kollaros2, C Plemmenos2

  • 1National and Kapodistrian University of Athens, Faculty of Medicine, Medical Physics Laboratory, Athens, Greece.

Physica Medica : PM : an International Journal Devoted to the Applications of Physics to Medicine and Biology : Official Journal of the Italian Association of Biomedical Physics (AIFB)
|March 10, 2018
PubMed

Insights

Paediatric radiation doses in cardiac interventional procedures vary significantly by age and procedure type. Establishing Local Diagnostic Reference Levels (LDRLs) is challenging due to this variability and the need for standardized nomenclature.

Area of Science:

  • Medical Physics
  • Radiology
  • Paediatric Cardiology

Background:

  • Radiation dose assessment in paediatric procedures is crucial for patient safety.
  • Dedicated cardiology hospitals require specific evaluations of radiation exposure.
  • Characterizing dose variations aids in establishing safety benchmarks.

Purpose of the Study:

  • To evaluate paediatric radiation doses in cardiac interventional procedures.
  • To define Local (Institutional) Diagnostic Reference Levels (LDRLs) based on patient age.
  • To identify patterns in dose variation for paediatric cardiac interventions.

Main Methods:

  • Analysis of 477 paediatric cardiac interventional cases over three years.
  • Data collection included Fluoroscopy Time (FT), Number of Frames (N), and Kerma Area Product (PKA).
  • Dose metrics were analyzed across different age ranges (<1, 1-5, 5-10, 10-16 years).

Main Results:

  • Median PKA values ranged from 2.0 to 14.0 Gy·cm² across age groups.
  • Median FT ranged from 5.7 to 6.5 min, and median N ranged from 940 to 1403.
  • Significant variation in patient dose data was observed, influenced by procedure type and patient age.

Conclusions:

  • Defining LDRLs for paediatric cardiac interventions is challenging due to wide dose variations.
  • Lack of standardized paediatric interventional cardiology DRLs hinders the identification of best practices.
  • Consensus on procedure nomenclature and grouping is needed for effective dose comparison.

Keywords:
Institutional Local Diagnostic Reference LevelsInterventional CardiologyKerma Area ProductPaediatric patients

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