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Diagnostic Reference Levels in pediatric interventional cardiology: A multicenter study by the French cohort in

Bouchra Habib Geryes1, Soline Bondet De La Bernardie2, Sébastien Hascoet3

  • 1Pediatric Radiology Department, Hôpital Universitaire Necker Enfants Malades, AP-HP, Université Paris Cité, Paris, France.

Plos One
|September 17, 2025
PubMed

Insights

This study establishes the first multicenter diagnostic reference levels (DRLs) for pediatric interventional cardiology (IC) procedures in France. These DRLs provide crucial benchmarks for optimizing radiation exposure in children undergoing cardiac interventions.

Area of Science:

  • Medical Imaging
  • Pediatric Cardiology
  • Radiation Oncology

Background:

  • Pediatric interventional cardiology (IC) is vital for treating congenital heart disease (CHD) in children.
  • Ionizing radiation used in pediatric IC procedures poses long-term health risks.
  • Optimization of radiation dose is essential in pediatric cardiac interventions.

Purpose of the Study:

  • To establish multicenter diagnostic reference levels (DRLs) for pediatric IC procedures in France.
  • To provide data for optimizing radiation exposure within the COCCINELLE cohort.
  • To contribute to the HARMONIC European project's goals.

Main Methods:

  • Retrospective analysis of radiation dose metrics from 1815 pediatric IC procedures (2018-2020).
  • Data stratified by patient weight (<5 to 50-<80 kg) and procedure type.
  • Calculation of median and 75th percentile values for dose-area product (DAP) and fluoroscopy time (FT) to define DRLs.

Main Results:

  • Significant variations in DAP were observed across procedure types and weight groups.
  • Fluoroscopy time did not show significant variation.
  • Established typical-DRL values for DAP across various procedures and weight strata.

Conclusions:

  • This study presents the first multicenter DRLs for pediatric IC in France.
  • These DRLs serve as benchmarks for radiation dose optimization in pediatric cardiology.
  • Findings support the development of future national and international guidelines for pediatric IC.
Abstract

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