The establishment of local diagnostic reference levels for paediatric interventional cardiology

Radiation doses from fluoroscopically guided cardiac catheterization procedures in children and young adults in the United Kingdom: a multicentre study

“…[1][2][3] The radiation doses and associated risks from cardiac catheterizations in children and young people have recently received considerable attention, [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] although relatively fewer data on doses in the UK have been published. 7,17,22,23 Most previous assessments have been based on kerma area product (P KA , also known as dose-area product), defined as collision air kerma integrated over beam area. 24 P KA is a dose indicator rather than a measure of actual patient dose.…”

Estimates of Diagnostic Reference Levels for Pediatric Peripheral and Abdominal Fluoroscopically Guided Procedures

“…Indicators of the complexity of an interventional fluoroscopic procedure are total fluoroscopy time and total number of recorded DSA images [33]. To compress the distribution of AK and DAP due to the varying complexities of the 408 procedures, fluoroscopy and fluorography radiation doses of individual cases were normalized by the fluoroscopy time and the number of recorded DSA images for each procedure, respectively, to provide four rates: DAP/min and AK/min for fluoroscopy; and DAP/number of DSA images and AK/number of DSA images for fluorography.…”

“…Over the past decade, 13 published studies on the estimated doses during adult vascular angiographic procedures, the majority from neurovascular laboratories, were identified in the literature [8][9][10][11][12][13][14][15][16][17][18][19][20]. During the same time period, the estimated doses surveyed at seven pediatric cardiac catheterization departments were reported [21][22][23][24][25][26][27], and three different groups reported estimated patient doses during pediatric neurointerventions [28][29][30]. However, information on the estimated doses during pediatric peripheral and abdominal fluoroscopically guided studies from which appropriate DRLs could be established could not be identified in the published literature.…”

Comparison of pediatric radiation dose and vessel visibility on angiographic systems using piglets as a surrogate: antiscatter grid removal vs. lower detector air kerma settings with a grid — a preclinical investigation

“…(1)(2)(3) To this end, numerous authors over a number of years have recommended removing the antiscatter grid from the X-ray beam during fluoroscopic examinations of small children. (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) While some authors have quantified the reduction in patient dose to these pediatric patients, (7,13,(16)(17)(18)(19) the loss of image quality associated with this reduction in patient dose has been measured only on a limited basis (7,9,14,16,17,20) with phantoms as opposed to live models. In addition, the studies that do exist (7,20,21) tend to address the pediatric interventional cardiology laboratory application as opposed to the pediatric interventional radiology laboratory.…”