Pilot program on patient dosimetry in pediatric interventional cardiology in Chile

Abstract

The dose values reported in this paper were lower than those published in the previous work for the same age groups as a result of the optimization actions carried out by cardiologists and medical physicists with the support of the IAEA. Methodology and results will be used as a starting point for a wider survey in Chile and Latin America with the goal to obtain regional diagnostic reference levels as recently recommended by the International Commission on Radiological Protection for interventional procedures.

Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values

“…As in other similar studies, [8][9][10]17 we use the DAP quantity, most familiar to interventional cardiologists, equivalent to air kerma-area product (KAP) as proposed by the international commission on radiological units (ICRU), 13 and we use the quantity cumulative dose (CD), referred to in the standard IEC 60601-2-43 (Ref. 19) and equivalent to the incident air kerma without backscatter 13 at the patient entrance reference point.…”

“…The sample of collected clinical procedures was divided into two groups (diagnostic and therapeutic) and initially grouped into four age ranges (<1 yr, 1 to <5 yr, 5 to <10 yr, and 10 to <16 yr) as in our previous paper 9 and in the majority of pediatric patient dose surveys in Europe. The DAP/body weight ratio for all procedures was also calculated.…”

“…6,7 The dosimetric quantities used to establish DRLs for PIC procedures have been categorized in most of the published papers by patient age. [8][9][10] However, Onnasch et al, 11 and subsequently, Chida et al, 12 found that patient weight is one of the main causes of increased dose-area product (DAP). 13 Therefore, we also proposed considering the ratio between DAP and body weight as part of the strategy to establish DRLs for children.…”

“…As a result, pilot programs have been established on radiation protection and patient dosimetry in PIC procedures, including training on radiation protection for both patients and staff focused on PIC. 9,10 This paper presents the results of a patient dose evaluation program spanning the last three years in the largest pediatric hospital in Chile, which manages approximately 60% of all PIC procedures carried out in the country. The dosimetry program permitted the proposal of a set of local DRLs for different types of procedures and age range.…”

Riscos da Radiação X e a Importância da Proteção Radiológica na Cardiologia Intervencionista: Uma Revisão Sistemática

“…11,28,48 Nesses países, tem se observado a redução significativa da dose de radiação ao paciente. 18,49 Os níveis de referência, portanto, estão bem estabelecidos para os procedimentos comuns e são exigidos pelas recomendações internacionais. 9,11,28,48 As doses nos procedimentos de Cardiologia Intervencionista podem chegar a variar em um fator 10 (Tabela 1) em procedimentos complexos, como a intervenção em uma oclusão coronária crônica, 50 a substituição de uma válvula aórtica transtorácica, 51 ou o reparo de um aneurisma endovascular torácico-abdominal, 52 os quais podem exceder a dose efetiva de 100 mSv.…”