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Patient radiation doses in paediatric interventional cardiology procedures: a review

Lookup NU author(s): Dr Richard Harbron, Professor Mark Pearce, Dr Claire-Louise Chapple

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Abstract

A large number of investigations into the radiation doses from x-ray guided interventionalcardiology procedures in children have been carried out in recent years. A review wasconducted of these studies, gathering data on kerma area product (PKA), fluoroscopicscreening time (FT), air kerma, and estimates of effective dose and organ doses. The majorityof studies focus on PKA and FT with no estimation of dose to the patient. A greater than tenfoldvariation in average PKA was found between different studies, even where data werestratified by patient age or weight. Typical values of PKA were 0.6-10 Gy·cm2 (<1 year/10kg), 1.5-30 Gy·cm2 (1-5 y), 2-40 Gy·cm2 (5-10 y), 5-100 Gy·cm2 (10-16 y) and 10-200Gy·cm2 (>15y). PKA was lowest for heart biopsy (0.3-10 Gy·cm2 for all ages combined) andatrial septostomy (0.4-4.0 Gy·cm2), and highest for pulmonary artery angioplasty (1.5-35Gy·cm2) and right ventricular outflow tract dilatation (139 Gy·cm2). Most estimates ofpatient dose were in the form of effective dose (typically 3-15 mSv) which is of limitedusefulness in individualised risk assessment. Few studies estimated organ doses. Despiteadvances in radiation protection, recent publications have reported surprisingly large doses,as represented by PKA and air kerma. There is little indication of a fall in these dose indicatorsover the last 15 years. Nor is there much suggestion of a fall in doses associated with the useof flat panel detectors, as opposed to image intensifiers. An assessment of the impact ofradiation dose in the context of overall patient outcome is required.


Publication metadata

Author(s): Harbron RW, Dreuil S, Bernier M-O, Pearce MS, Thierry-Chef I, Chapple C-L, Baysson H

Publication type: Review

Publication status: Published

Journal: Journal of Radiological Protection

Year: 2016

Volume: 36

Issue: 4

Print publication date: 01/12/2016

Online publication date: 28/11/2016

Acceptance date: 12/07/2016

ISSN (print): 0952-4746

ISSN (electronic): 1361-6498

URL: http://dx.doi.org/10.1088/0952-4746/36/4/R131

DOI: 10.1088/0952-4746/36/4/R131


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