Two-year experience of radiation dose watch for pediatric general fluoroscopic examinations

The radiation dose of pediatric general fluoroscopy exams has historically been a topic of concern, with ongoing efforts and significant progress made.

The purpose of this study is to evaluate dose performance with a dose monitor program for pediatric general fluoroscopy.

Pediatric general fluoroscopy exams performed between April 1, 2020, and Dec. 31, 2022 were collected and monitored. For each exam, fluoroscopy time, dose-area-product (DAP), reference air kerma (RAK), and patient demographic information were analyzed. RAK, DAP, and fluoroscopy time were tested using Pearson's correlation methods for the three most frequently performed procedures. The influence of patient habitus on dose was studied using linear regression methods. Dose performance among radiologists was compared and so the Wilcoxon signed-rank test between radiologists with ≤ 5 years and > 5 years of experience post fellowship. A significance level of P<0.05 was used to determine statistical significance.

A total of 12,029 cases were analyzed and the median RAK values range from 0.10 mGy to 1.30 mGy. RAK demonstrated a stronger correlation with DAP (upper gastrointestinal (UGI), R=0.97; P<0.0001) than with fluoroscopy time (UGI, R=0.19; P<0.0001). RAK values were linearly correlated with patient weight (UGI, R=0.49; P<0.0001). A stable trend of median RAK values was observed across the studied time periods. Radiologists with ≤ 5 years' experience showed significantly lower (P<0.0001) RAK than those with > 5 years' experience.

Variations of pediatric general fluoroscopy dose performance were observed when comparing with other investigations. This study demonstrated that both patient size and operator experience influence radiation output in general fluoroscopy, factors that should be considered for pediatric fluoroscopy procedures.