title: Direct measurement of a patient's entrance skin dose during pediatric cardiac catheterization.
abstract: Children with complex congenital heart diseases often require repeated cardiac catheterization; however, children are more radiosensitive than adults. Therefore, radiation-induced carcinogenesis is an important consideration for children who undergo those procedures. We measured entrance skin doses (ESDs) using radio-photoluminescence dosimeter (RPLD) chips during cardiac catheterization for 15 pediatric patients (median age, 1.92 years; males, n = 9; females, n = 6) with cardiac diseases. Four RPLD chips were placed on the patient's posterior and right side of the chest. Correlations between maximum ESD and dose-area products (DAP), total number of frames, total fluoroscopic time, number of cine runs, cumulative dose at the interventional reference point (IRP), body weight, chest thickness, and height were analyzed. The maximum ESD was 80 ± 59 (mean ± standard deviation) mGy. Maximum ESD closely correlated with both DAP (r = 0.78) and cumulative dose at the IRP (r = 0.82). Maximum ESD for coiling and ballooning tended to be higher than that for ablation, balloon atrial septostomy, and diagnostic procedures. In conclusion, we directly measured ESD using RPLD chips and found that maximum ESD could be estimated in real-time using angiographic parameters, such as DAP and cumulative dose at the IRP. Children requiring repeated catheterizations would be exposed to high radiation levels throughout their lives, although treatment influences radiation dose. Therefore, the radiation dose associated with individual cardiac catheterizations should be analyzed, and the effects of radiation throughout the lives of such patients should be followed.
authors: Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
authors: Lue
authors: L
authors: Sun
authors: Department of Anesthesiology, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
authors: Yusuke
authors: Y
authors: Mizuno
authors: Department of Pediatrics, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
authors: Mari
authors: M
authors: Iwamoto
authors: Department of Anesthesiology, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
authors: Takahisa
authors: T
authors: Goto
authors: Oarai Research Center, Chiyoda Technol Corporation, 3681 Naritacho, Oarai-machi, Higashiibaraki-gun, Ibaraki 311-1313, Japan.
authors: Yasuhiro
authors: Y
authors: Koguchi
authors: Oarai Research Center, Chiyoda Technol Corporation, 3681 Naritacho, Oarai-machi, Higashiibaraki-gun, Ibaraki 311-1313, Japan.
authors: Yuka
authors: Y
authors: Miyamoto
authors: Proton Medical Research Center, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
authors: Koji
authors: K
authors: Tsuboi
authors: Department of Radiological Technology, School of Health Sciences, Faculty of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
authors: Koichi
authors: K
authors: Chida
authors: Department of Radiological Health Science, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan moritake@med.uoeh-u.ac.jp.
authors: Takashi
authors: T
authors: Moritake
mesh_terms: D006328:Cardiac Catheterization / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D062791:Optically Stimulated Luminescence Dosimetry; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000009:adverse effects*; D012867:Skin / Q000528:radiation effects*
keywords: cardiac catheterization; dosimetry; entrance skin dose; pediatric heart disease