title: A comparison of radiation dose between standard and 3D angiography in congenital heart disease.
abstract: BACKGROUND
  The use of three-dimensional rotational angiography (3D-RA) to assess patients with congenital heart diseases appears to be a promising technique despite the scarce literature available.
  
  
  OBJECTIVE
  The objective of this study was to describe our initial experience with 3D-RA and to compare its radiation dose to that of standard two-dimensional angiography (2D-SA).
  
  
  METHODS
  Between September 2011 and April 2012, 18 patients underwent simultaneous 3D-RA and 2D-SA during diagnostic cardiac catheterization. Radiation dose was assessed using the dose-area-product (DAP).
  
  
  RESULTS
  The median patient age and weight were 12.5 years and 47.5 Kg, respectively. The median DAP of each 3D-RA acquisition was 1093µGy.m2 and 190µGy.m2 for each 2D-SA acquisition (p<0.01). In patients weighing more than 45Kg (n=7), this difference was attenuated but still significant (1525 µGy.m2 vs.413µGy.m2, p=0.01). No difference was found between one 3D-RA and three 2D-SA (1525µGy.m2 vs.1238 µGy.m2, p = 0.575) in this population. This difference was significantly higher in patients weighing less than 45Kg (n=9) (713µGy.m2 vs.81µGy.m2, P = 0.008), even when comparing one 3D-RA with three 2D-SA (242µGy.m2, respectively, p<0.008). 3D-RA was extremely useful for the assessment of conduits of univentricular hearts, tortuous branches of the pulmonary artery, and aorta relative to 2D-SA acquisitions.
  
  
  CONCLUSIONS
  The radiation dose of 3D-RA used in our institution was higher than those previously reported in the literature and this difference was more evident in children. This type of assessment is of paramount importance when starting to perform 3D-RA.
authors.forename: João Luiz Langer
authors.initials: JL
authors.lastname: Manica
authors.forename: Mônica Scott
authors.initials: MS
authors.lastname: Borges
authors.forename: Rogério Fachel de
authors.initials: RF
authors.lastname: Medeiros
authors.forename: Leandro dos Santos
authors.initials: Ldos S
authors.lastname: Fischer
authors.forename: Gabriel
authors.initials: G
authors.lastname: Broetto
authors.forename: Raul Ivo
authors.initials: RI
authors.lastname: Rossi Filho
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D008297:Male; D011829:Radiation Dosage; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D055815:Young Adult