title: Radiation dose in pneumatic reduction of ileo-colic intussusceptions--results from a single-institution study.
abstract: BACKGROUND
  Air enema under fluoroscopy is a well-accepted procedure for the treatment of childhood intussusception. However, the reported radiation doses of pneumatic reduction with conventional fluoroscopy units have been high in decades past.
  
  
  OBJECTIVE
  To compare current radiation doses at our institution to past doses reported by others for fluoroscopic-guided pneumatic reduction of ileo-colic intussusception in children.
  
  
  METHODS
  Since 2007 radiologists and residents in our department who perform reduction of intussusceptions have received a radiation risk training. We retrospectively analyzed the data of 45 children (5 months-8 years) who underwent a total of 48 pneumatic reductions of ileo-colic intussusception between 2008 and 2012. We analyzed data for screening time and dose area product (DAP) and compared these data to those reported up to and including the year 2000.
  
  
  RESULTS
  Our mean screening time measured by the DAP-meter was 53.8 s (range 1-320 s, median 33.0 s). The mean DAP was 11.4 cGy ∙ cm(2) (range 1-145 cGy ∙ cm(2), median 5.45 cGy ∙ cm(2)). There was one bowel perforation, in a 1-year-old boy requiring surgical revision. Only three studies in the literature presented radiation exposure results on children who received pneumatic or hydrostatic reduction of intussusception under fluoroscopy. Screening times and dose area products in those studies, which were published in the 1990 s and in the year 2000, were substantially higher than those in our sample.
  
  
  CONCLUSIONS
  Low-frequency pulsed fluoroscopy and other dose-saving keys as well as the radiation risk training might have helped to improve the quality of the procedure in terms of radiation exposure.
authors.affiliation: Institute for Diagnostic, Interventional, and Pediatric Radiology, Inselspital, University Hospital Bern, Freiburgstr. 10, 3010, Bern, Switzerland, jennifer.cullmann@insel.ch.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Cullmann
authors.forename: Johannes T
authors.initials: JT
authors.lastname: Heverhagen
authors.forename: Stefan
authors.initials: S
authors.lastname: Puig
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007077:Ileal Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D007082:Ileum / Q000000981:diagnostic imaging / Q000601:surgery; D007223:Infant; D007443:Intussusception / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D011829:Radiation Dosage; D015641:Radiography, Interventional; D012189:Retrospective Studies