title: Patient radiation doses and reference levels in pediatric interventional radiology.
abstract: OBJECTIVE
  To describe, in a multicentric paediatric population, reference levels (RLs) for three interventional radiological procedures.
  
  
  METHODS
  From January 2012 to March 2015, children scheduled for an interventional radiological procedure in two French tertiary centres were retrospectively included and divided into four groups according to age: children younger than 2 years (A1), aged 2-7 years (A5), 8-12 years (A10) and 13-18 years (A15). Three procedures were identified: cerebral digital subtraction angiography (DSA), brain arteriovenous malformation (bAVM) embolization, and head and neck superficial vascular malformation (SVM) percutaneous sclerotherapy. Demographic and dosimetric data, including dose area product (DAP), were collected.
  
  
  RESULTS
  550 procedures were included. For DSA (162 procedures), the proposed RL values in DAP were 4, 18, 12 and 32 Gy∙cm2in groups A1, A5, A10 and A15, respectively. For bAVM embolization (258 procedures), values were 33, 70, 105 and 88 Gy∙cm2in groups A1, A5, A10 and A15, respectively. For SVM sclerotherapy (130 procedures), values were 350, 790, 490 and 248 mGy∙cm2in groups A1, A5, A10 and A15, respectively.
  
  
  CONCLUSIONS
  Consecutive data were available to permit a proposal of reference levels for three major paediatric interventional radiology procedures.
  
  
  CONCLUSIONS
  • We determined reference levels (RLs) for bAVM embolization, DSA and SVM sclerotherapy. • The proposed RLs will permit benchmarking practice with an external standard. • The proposed RLs by age may help to develop paediatric dose guidelines.
authors.affiliation: Department of Paediatric Radiology, Hôpital Universitaire Necker Enfants Malades, Paris, France.
authors.forename: Bouchra
authors.initials: B
authors.lastname: Habib Geryes
authors.affiliation: Department of Neuroradiology, Hôpital Bicêtre, Hôpitaux Universitaires Paris-Sud, Le Kremlin Bicêtre, France.
authors.forename: Adeline
authors.initials: A
authors.lastname: Bak
authors.affiliation: Department of Paediatric Radiology, Hôpital Universitaire Necker Enfants Malades, Paris, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Lachaux
authors.affiliation: Department of Neuroradiology, Hôpital Bicêtre, Hôpitaux Universitaires Paris-Sud, Le Kremlin Bicêtre, France.
authors.forename: Augustin
authors.initials: A
authors.lastname: Ozanne
authors.affiliation: Department of Paediatric Radiology, Hôpital Universitaire Necker Enfants Malades, Paris, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Boddaert
authors.affiliation: Department of Paediatric Radiology, Hôpital Universitaire Necker Enfants Malades, Paris, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Brunelle
authors.affiliation: Department of Paediatric Radiology, Hôpital Universitaire Necker Enfants Malades, Paris, France. o.naggara@ch-sainte-anne.fr.|Université Paris Descartes Sorbonne Paris Cité, Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasculaire, Centre Hospitalier Sainte-Anne, Paris, France. o.naggara@ch-sainte-anne.fr.|Department of Neuroradiology, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR894, Centre Hospitalier Sainte-Anne, 1 rue Cabanis, 75014, Paris, France. o.naggara@ch-sainte-anne.fr.
authors.forename: Olivier
authors.identifier: http://orcid.org/0000-0002-9544-379X
authors.initials: O
authors.lastname: Naggara
authors.affiliation: Department of Neuroradiology, Hôpital Bicêtre, Hôpitaux Universitaires Paris-Sud, Le Kremlin Bicêtre, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Saliou
mesh_terms: D000293:Adolescent; D015901:Angiography, Digital Subtraction / Q000592:standards*; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000592:standards*; D005260:Female; D005471:Fluoroscopy / Q000592:standards; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging; D008297:Male; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000592:standards*; D011874:Radiometry; D012015:Reference Standards; D012189:Retrospective Studies; D015911:Sclerotherapy / Q000592:standards*
keywords: Interventional neuroradiology; Paediatric; Radiation dose; Radiation protection; Reference level