[Paediatric varicocele embolization dosimetric study].
OBJECTIVE
Varicocele is a benign condition, often asymptomatic, that appears among young men with a normal life expectancy. The endovascular embolization is a minimally invasive therapeutic procedure indicated for varicocele treatment, although there are safe surgical alternatives. It is essential to know the radiological risk associated with the procedure. The aim of this work is to determine local dose levels in paediatric varicocele embolization, in order to minimize and to estimate the radiological risk.


METHODS
In the retrospective study, 15 cases were analyzed, all of which were paediatric patients (10-18 years). The screening time and the dose-area product were known, as provided by the X-ray equipment. In the prospective study, dose optimization techniques were implemented, and in addition, radiographic films were used in order to verify the radiated zone and termoluminiscense dosimeters in order to evaluate gonad dose and maximum skin dose for 10 paediatric patients (10-16 years).


RESULTS
In the retrospective group, the average effective dose was 8.8 mSv. The total average risk of a fatal cancer induction in any location was 0.16%, and 0.0007% for hereditary effects. The maximum skin dose was 250 mGy, which is far from the threshold for deterministic effects (2 Gy). In the prospective group, dose and radiological risk decreased by more than 70%.


CONCLUSIONS
Hereditary effects were very low in contrast to the fatal cancer risk estimation. According to the results we can discard deterministic effects, unless complications appear in the procedure. Radiation exposure must be optimized. It is necessary that medical staff know the radiological risks associated with the intervention, and inform the patients about them.
Calama Santiago
J A
JA
Servicio de Dosimetría y Radioprotección, Hospital General Universitario Gregorio Marañón, Madrid. juan_calama@hotmail.com
Penedo Cobos
J M
JM
Molina López
M Y
MY
González Ruiz
C
C
García Mollá
R
R
Sierra Díaz
F
F
D000293:Adolescent; D002648:Child; D004621:Embolization, Therapeutic / Q000379:methods; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011829:Radiation Dosage; D011859:Radiography; D012189:Retrospective Studies; D014646:Varicocele / Q000000981:diagnostic imaging* / Q000628:therapy*