title: Radiation doses from fluoroscopically guided cardiac catheterization procedures in children and young adults in the United Kingdom: a multicentre study.
abstract: OBJECTIVE
  To gather data on radiation doses from fluoroscopically guided cardiac catheterization procedures in patients aged under 22 years at multiple centres and over a prolonged period in the UK. To evaluate and explain variation in doses. To estimate patient-specific organ doses and allow for possible future epidemiological analysis of associated cancer risks.
  
  
  METHODS
  Patient-specific data including kerma area product and screening times from 10,257 procedures carried out on 7726 patients at 3 UK hospitals from 1994 until 2013 were collected. Organ doses were estimated from these data using a dedicated dosimetry system based on Monte Carlo computer simulations.
  
  
  RESULTS
  Radiation doses from these procedures have fallen significantly over the past two decades. The organs receiving the highest doses per procedure were the lungs (median across whole cohort, 20.5 mSv), heart (19.7 mSv) and breasts (13.1 mSv). Median cumulative doses, taking into account multiple procedures, were 23.2, 22.2 and 16.7 mSv for these organs, respectively. Bone marrow doses were relatively low (median per procedure, 3.2 mSv; cumulative, 3.6 mSv).
  
  
  CONCLUSIONS
  Most modern cardiac catheterizations in children are moderately low-dose procedures. Technological advances appear to be the single most important factor in the fall in doses. Patients undergoing heart transplants undergo the most procedures. An epidemiological assessment of cancer risks following these procedures may be possible, especially using older data when doses were higher.
  
  
  CONCLUSIONS
  This is the first large-scale, patient-specific assessment of organ doses from these procedures in a young population.
authors: 1 The Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors: R W
authors: RW
authors: Harbron
authors: M S
authors: MS
authors: Pearce
authors: J A
authors: JA
authors: Salotti
authors: K
authors: K
authors: McHugh
authors: C
authors: C
authors: McLaren
authors: L
authors: L
authors: Abernethy
authors: S
authors: S
authors: Reed
authors: J
authors: J
authors: O'Sullivan
authors: C-L
authors: CL
authors: Chapple
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009010:Monte Carlo Method; D011829:Radiation Dosage; D012307:Risk Factors; D013819:Thermoluminescent Dosimetry; D006113:United Kingdom
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