title: Patient radiation doses in paediatric interventional cardiology procedures: a review.
abstract: A large number of investigations into the radiation doses from x-ray guided interventional cardiology procedures in children have been carried out in recent years. A review was conducted of these studies, gathering data on kerma area product (PKA), fluoroscopic screening time (FT), air kerma, and estimates of effective dose and organ doses. The majority of studies focus on PKAand FT with no estimation of dose to the patient. A greater than ten-fold variation in average PKAwas found between different studies, even where data were stratified by patient age or weight. Typical values of PKAwere 0.6-10 Gy · cm2(<1 year/10 kg), 1.5-30 Gy · cm2(1-5 years), 2-40 Gy · cm2(5-10 years), 5-100 Gy · cm2(10-16 years) and 10-200 Gy · cm2(>16 years). PKAwas lowest for heart biopsy (0.3-10 Gy · cm2for all ages combined) and atrial septostomy (0.4-4.0 Gy · cm2), and highest for pulmonary artery angioplasty (1.5-35 Gy · cm2) and right ventricular outflow tract dilatation (139 Gy · cm2). Most estimates of patient dose were in the form of effective dose (typically 3-15 mSv) which is of limited usefulness in individualised risk assessment. Few studies estimated organ doses. Despite advances in radiation protection, recent publications have reported surprisingly large doses, as represented by PKAand air kerma. There is little indication of a fall in these dose indicators over the last 15 years. Nor is there much suggestion of a fall in doses associated with the use of flat panel detectors, as opposed to image intensifiers. An assessment of the impact of radiation dose in the context of overall patient outcome is required.
authors.affiliation: Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne, NE1 4LP, UK. NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Newcastle University, Newcastle-upon-Tyne, UK.
authors.forename: R W
authors.initials: RW
authors.lastname: Harbron
authors.forename: S
authors.initials: S
authors.lastname: Dreuil
authors.forename: M-O
authors.initials: MO
authors.lastname: Bernier
authors.forename: M S
authors.initials: MS
authors.lastname: Pearce
authors.forename: I
authors.initials: I
authors.lastname: Thierry-Chef
authors.forename: C-L
authors.initials: CL
authors.lastname: Chapple
authors.forename: H
authors.initials: H
authors.lastname: Baysson
mesh_terms: D002309:Cardiology; D002648:Child; D006801:Humans; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D015641:Radiography, Interventional; D018570:Risk Assessment