title: Effective radiation dose in computed tomographic angiography of the chest and diagnostic cardiac catheterization in pediatric patients.
abstract: Computed tomographic angiography (CTA) and cardiac catheterization are useful adjuncts to echocardiography for delineating cardiovascular anatomy in pediatric patients. These studies require ionizing radiation, and it is paramount to understand the amount of radiation pediatric patients receive when these tests are performed. Modern dosimetry methods facilitate the conversion of radiation doses of varying units into an effective radiation dose. To compare the effective radiation dose between nongated CTA of the chest and diagnostic cardiac catheterization in pediatric patients. This is a retrospective cohort study of patients of patients who underwent either nongated CTA of the chest or diagnostic cardiac catheterization between July 2009 and April 2010. Fifty patients were included in each group as consecutive samples at a single tertiary care center. An effective radiation dose (mSv) was formulated using conversion factors for each group. The median effective dose (ED) for the CTA group was 0.74 mSv compared with 10.8 mSv for the catheterization group (p < 0.0001). The median ED for children <1 year of age in the CTA group was 0.76 mSv compared with 13.4 mSv for the catheterization group (p < 0.0001). Nongated CTA of the chest exposes children to 15 times less radiation than diagnostic cardiac catheterization. Unless hemodynamic data are necessary, CTA of the chest should be considered in lieu of diagnostic cardiac catheterization in patients with known or presumed cardiac disease who need additional imaging beyond echocardiography.
authors.affiliation: Department of Pediatrics (Cardiology), The Children's Heart Program, Medical University of South Carolina, 165 Ashley Ave, MSC 915, Charleston, SC 29425, USA. timotheuswatson@yahoo.com
authors.forename: Timotheus G
authors.initials: TG
authors.lastname: Watson
authors.forename: Eugene
authors.initials: E
authors.lastname: Mah
authors.forename: U
authors.initials: U
authors.lastname: Joseph Schoepf
authors.forename: Lydia
authors.initials: L
authors.lastname: King
authors.forename: Walter
authors.initials: W
authors.lastname: Huda
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Hlavacek
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000792:Angiography / Q000009:adverse effects / Q000379:methods; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods; D015641:Radiography, Interventional / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D013909:Thorax / Q000528:radiation effects; D014057:Tomography, X-Ray Computed / Q000009:adverse effects* / Q000379:methods