Few data are available regarding radiation exposure to children during cardiac catheterization. Using lithium fluoride thermoluminescent dosimeters, radiation exposure was measured during precatheterization chest roentgenography, fluoroscopy (hemodynamic assessment phase of catheterization) and cineangiography in 30 infants and children, ages 3 days to 21 years. Dosimeters were placed over the eyes, thyroid, anterior chest, posterior chest, anterior abdomen, posterior abdomen and gonads. Average absorbed chest doses were 24.5 mR during chest roentgenography, 5810 mR during catheterization fluoroscopy and 1592 mR during cineangiography. During the complete catheterization, average doses were 26 mR to the eyes, 431 mR to the thyroid area, 150 mR to the abdomen and 11 mR to the gonads. Radiation exposure during pediatric cardiac catheterization is low to the eyes and gonads but high to the chest and thyroid area. To decrease radiation dosage we suggest (1) low pulse-rate fluoroscopy; (2) substitution of contrast echocardiography for cineangiography; (3) large-plate abdominal/gonadal shielding; (4) a selective shield for thyroid area; (5) a very small field during catheter manipulation. Minimum radiation consistent with accurate diagnosis is optimal; however, erroneous or incomplete diagnosis is more dangerous than radiation-related hazards.
A b~t r a c t L~~X e gas is currently being used for a variety of lung scanning studies in the evaluation ofpatients with pulmonary disease. This radionuclide was selected for a number of reasons: (1) it does not react chemically with body tissues; (2) its physical half-life is such that useful quantities can be supplied from distant sources; (3) its biological half-life is in the order of minutes and the absorbed dose to the patient, even from millicurie amounts, is minimal; (4) only nominal shielding is required for the X and gamma emissions; and (5) commercial dose calibrators are available, which express activity directly in mCi or pCi.In the chain of transfers necessary from receipt of the radioactive gas to final disposal of waste, leakage must be continually guarded against. In our experience over several years, leakage, when it has occurred, has most often been caused by excessive strain on connecting lines.However, film badge exposures for personnel involved have been consistently minimal and no overexposures have occurred, although we have handled as much as 2 Ci per month. Accident pre-planning, including careful consideration of containment and dispensing apparatus, ventilation and exhaust requirements, and dry runs, have contributed to this record.
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