title: Estimation of radiation dose and risk to children undergoing cardiac catheterization for the treatment of a congenital heart disease using Monte Carlo simulations.
abstract: BACKGROUND
  Children diagnosed with congenital heart disease often undergo cardiac catheterization for their treatment, which involves the use of ionizing radiation and therefore a risk of radiation-induced cancer.
  
  
  OBJECTIVE
  The purpose of this study was to calculate the effective and equivalent organ doses (H(T)) in those children and estimate the risk of exposure-induced death.
  
  
  METHODS
  Fifty-three children were divided into three groups: atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA). In all procedures, the exposure conditions and the dose-area product meters readings were recorded for each individual acquisition. Monte Carlo simulations were run using the PCXMC 2.0 code and mathematical phantoms simulating a child's anatomy. The H(T) values to all irradiated organs and the resulting E and risk of exposure-induced death values were calculated.
  
  
  RESULTS
  The average dose-area product values were, respectively, 40 ± 12 Gy·cm(2) for the ASD, 17.5 ± 0.7 Gy·cm(2) for the VSD and 9.5 ± 1 Gy·cm(2) for the PDA group. The average E values were 40 ± 12, 22 ± 2.5 and 17 ± 3.6 mSv for ASD, VSD and PDA groups, respectively. The respective estimated risk of exposure-induced death values per procedure were 0.109, 0.106 and 0.067%.
  
  
  CONCLUSIONS
  Cardiac catheterizations in children involve a considerable risk for radiation-induced cancer that has to be further reduced.
authors.affiliation: Medical Physics Department, Medical School, University of Athens, 75 Mikras Asias, 11527, Athens, Greece.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Yakoumakis
authors.forename: Helen
authors.initials: H
authors.lastname: Kostopoulou
authors.forename: Triantafilia
authors.initials: T
authors.lastname: Makri
authors.forename: Anastastios
authors.initials: A
authors.lastname: Dimitriadis
authors.forename: Evaggelos
authors.initials: E
authors.lastname: Georgiou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Tsalafoutas
mesh_terms: D006328:Cardiac Catheterization / Q000401:mortality* / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003198:Computer Simulation; D005260:Female; D006115:Greece / Q000453:epidemiology; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D015233:Models, Statistical; D015995:Prevalence; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000401:mortality*; D011874:Radiometry / Q000706:statistics & numerical data*; D018570:Risk Assessment; D016019:Survival Analysis; D015996:Survival Rate