title: The lateral plane delivers higher dose than the frontal plane in biplane cardiac catheterization systems.
abstract: The objective of the study is to compare radiation dose between the frontal and lateral planes in a biplane cardiac catheterization laboratory. Tube angulation progressively increases patient and operator radiation dose in single-plane cardiac catheterization laboratories. This retrospective study captured biplane radiation dose in a pediatric cardiac catheterization laboratory between April 2010 and January 2014. Raw and time-indexed fluoroscopic, cineangiographic and total (fluoroscopic + cineangiographic) air kerma (AK, mGy) and kerma area product (PKA, µGym(2)/Kg) for each plane were compared. Data for 716 patients were analyzed: 408 (56.98 %) were male, the median age was 4.86 years, and the median weight was 17.35 kg. Although median beam-on time (minutes) was 4.2 times greater in the frontal plane, there was no difference in raw median total PKA between the two planes. However, when indexed to beam-on time, the lateral plane had a higher median-indexed fluoroscopic (0.75 vs. 1.70), cineangiographic (16.03 vs. 24.92), and total (1.43 vs. 5.15) PKA (p < 0.0001). The median time-indexed total PKA in the lateral plane is 3.6 times the frontal plane. This is the first report showing that the lateral plane delivers a higher dose than the frontal plane per unit time. Operators should consciously reduce the lateral plane beam-on time and incorporate this practice in radiation reduction protocols.
authors.affiliation: Division of Pediatric Cardiology, Stead Department of Pediatrics, University of Iowa Children's Hospital, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
authors.forename: Osamah
authors.initials: O
authors.lastname: Aldoss
authors.forename: Sonali
authors.initials: S
authors.lastname: Patel
authors.forename: Kyle
authors.initials: K
authors.lastname: Harris
authors.forename: Abhay
authors.initials: A
authors.lastname: Divekar
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002932:Cineangiography / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D007223:Infant; D007753:Laboratories; D008297:Male; D010372:Pediatrics; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000379:methods; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors