Radiation doses in a newly founded interventional cardiology department

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 (P ), fluoroscopic screening time (FT), air kerma, and estimates of effective dose and organ doses. The majority of studies focus on P and FT with no estimation of dose to the patient. A greater than ten-fold variation in average P was found between different studies, even where data were stratified by patient age or weight. Typical values of P were 0.6-10 Gy · cm (<1 year/10 kg), 1.5-30 Gy · cm (1-5 years), 2-40 Gy · cm (5-10 years), 5-100 Gy · cm (10-16 years) and 10-200 Gy · cm (>16 years). P was lowest for heart biopsy (0.3-10 Gy · cm for all ages combined) and atrial septostomy (0.4-4.0 Gy · cm), and highest for pulmonary artery angioplasty (1.5-35 Gy · cm) and right ventricular outflow tract dilatation (139 Gy · cm). 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 P and 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.

show abstract

A systematic review of conversion factors between kerma-area product and effective/organ dose for cardiac interventional fluoroscopy procedures performed in adult and paediatric patients

Brambilla

D'Alessio

Kuchcińska

et al. 2022

Phys. Med. Biol.

View full text Add to dashboard Cite

The aim of this systematic review is to undertake a critical appraisal of the evidence in the published literature concerning the conversion factors between kerma-area product (PKA) and effective/organ dose (DCED_PKA, DCHT_PKA) for cardiac interventional fluoroscopy procedures performed in adults and paediatric patients and to propose reference conversion factors to help standardize dose calculations. A search strategy utilizing MeSH headings in three databases identified 59 (adult) and 37 (paediatric) papers deemed eligible for the review. Exclusion criteria were adopted to select data only from publications which established DCED_PKA in patients using the ICRP103 tissue weighting factors. A time restriction from January 2007 was introduced in the search to capture the evolving trends of utilization of fluoroscopy-guided intervention technologies only in recent years. The suggested DCED_PKA and DCHT_PKA were synthesized by calculating the weighted averages of the values reported by the authors with weights corresponding to the study sample size. Eighteen studies for both adult (9) and paediatric (9) patients matching the search terms fulfilled the inclusion criteria. The suggested value for DCED_PKA in adult patients amounts to 0.24 mSvGy-1cm-2. The suggested values for DCHT_PKA ranged from a minimum of 0.15 mSvGy-1cm-2 for the female breast to a maximum of 0.97 mSvGy-1cm-2 for the lungs. The suggested values for DCED_PKA in paediatric patients ranged from 3.45 mSvGy-1cm-2 for the new-born to 0.49 mSvGy-1cm-2 in the 15-years age class. The suggested values for DCHT_PKA ranged from a minimum of 0.33 mSvGy-1cm-2 for bone marrow in the 15-years age class to a maximum of 11.49 mSvGy-1cm-2 for the heart in the new-born. To conclude, values of DCED_PKA/DCHT_PKA were provided for calculating effective/organ doses in cardiac interventional procedures. They can be useful for standardizing dose calculations, hence for comparison of the radiation detriment from different imaging procedures and in the framework of epidemiologic studies.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

hi@scite.ai

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Radiation doses in a newly founded interventional cardiology department

Cited by 6 publications

References 8 publications

Towards the definition of Institutional diagnostic reference levels in paediatric interventional cardiology procedures in Greece

Towards the definition of Institutional diagnostic reference levels in paediatric interventional cardiology procedures in Greece

Patient radiation doses in paediatric interventional cardiology procedures: a review

A systematic review of conversion factors between kerma-area product and effective/organ dose for cardiac interventional fluoroscopy procedures performed in adult and paediatric patients

Contact Info

Product

Resources

About