Typical values for pediatric interventional cardiology catheterizations: A standardized approach towards Diagnostic...

To define weight-stratified Diagnostic Reference Levels (DRL) typical values for pediatric interventional cardiology (IC) procedures adopting standardized methodologies proposed by ICRP135 and RP185.

Procedures performed at the pediatric catheterization room of the University-Hospital of Padua were analysed. Patients were stratified into body weight (BW) classes and DRL quantities were analysed for the most performed procedures. Typical values are defined as median P_KA and K_a,r. For database consistency, sampling and exclusion methods were precisely defined. The DRL-curve methodology by means of quantile regression median curves was investigated to assess the relationship between P_KA and weight. A like-to-like comparison with literature was made.

385 procedures were analysed. A large P_KA variability was observed in each weight group. P_KA differences across BW groups were not always statistically significant. When stratifying by procedure, P_KA variability decreased while correlations of P_KA and P_KA/FT with weight increased. The established typical values are generally lower than DRLs published data, whatever stratification method adopted. The highest P_KA median values were observed for Angioplasty (4.9 and 11.6 Gycm² for 5-<15 kg and 15-<30 kg, respectively). The DRL-curve approach shows promising results for Valvuloplasty and Angioplasty.

Typical values for pediatric IC DRL quantities were determined according to ICRP135 and RP185 methodologies. Stratification by BW classification does not reduce the variability of the P_KA values, unlike what happens when stratifying by procedure type. Results seem to corroborate that variability and exposure are more affected by procedure type and complexity than by patient weight. DRL-curve is a feasible approach.