Radiation Reduction in Paediatric Cardiac Catheterization: We Can Go Even Lower

Area of Science:

• Medical Imaging
• Pediatric Cardiology
• Radiation Safety

Background:

• Radiation reduction is crucial in pediatric cardiac catheterization.
• Protocol changes and technical upgrades can significantly reduce radiation exposure.

Purpose of the Study:

• To compare radiation exposure levels in a pediatric cardiac catheterization laboratory before and after implementing enhanced radiation reduction techniques.
• To evaluate the effectiveness of specific radiation reduction strategies.

Main Methods:

• Retrospective review of radiation exposures (dose area product, DAP/kg, Air Kerma, fluoroscopy time) for 16 procedure types from 2020-2022 (Unit A) and comparison with 2011-2014 data (Unit B).
• Implementation of techniques including 7.5 frames/s fluoroscopy, removal of antiscatter grids for children <30 kg, limited field of view, Philips ClarityIQ technology, and fostering a radiation-aware culture.

Main Results:

• Unit A demonstrated significantly lower median doses across 14 of 16 procedure types compared to Unit B.
• Total median DAP, DAP/kg, and Air Kerma were substantially lower in Unit A, despite longer fluoroscopy times.
• Specific procedures like pulmonary valvuloplasty and patent ductus arteriosus closure showed significantly reduced DAP in Unit A.

Conclusions:

• Advanced radiation reduction techniques, combined with dose-limiting protocols and technology, can achieve exposure levels lower than previously published.
• These findings highlight the potential for substantial radiation dose reduction in pediatric cardiac catheterization.