Aims and objectives
The aim of this work was to propose a set of national diagnostic reference levels (DRLs) for paediatric interventional cardiology (IC) procedures for the Irish population.
As has been previously reported [1],
little published information exists on radiation exposure in paediatric IC.
In recent times,
ICRP [2] have highlighted the need for DRLs in IC.
Furthermore,
RP 185 [3] states that “no NDRLs exist for paediatric IR procedures,
and LDRLs have been published only for paediatric interventional cardiology (IC) procedures.
The development of LDRLs for...
Methods and materials
Interventional Cardiology (IC) procedures from the national specialist paediatric centre,
Our Lady’s Children’s Hospital,
Dublin,
were collated over an 18 month period. All procedures were performed on a Siemens Artis Q-Zen.
Patient dose was recorded as kerma-area product (KAP).
Data for the most common examinations were collated and analysed for the presence of correlations between patient weight and KAP (using Spearman's Rank Order Correlation).
Where strong to moderate correlations were found,
a DRL for that examination was proposed as KAP per kg.
Results
Although all examinations contained numerous outliers,
strong to moderate correlations were found between KAP and patient weight for the majority of procedures (see table 1). The median (Q50) and 75th percentile (Q75) are presented for each examination as KAP per kg (see table 2). An example of how these values translate to a variety of patient weights is illustrated in figure 1,
for atrial septal defect closure.
Other studies have reported diagnostic reference levels for all IC procedures taken together [4,
5]. Table 3 compares...
Conclusion
Paediatric IC procedures present particular challenges whne atempting to calculate DRLs. The variety of the examinations,
the complexity of the procedures and experience of the operators all influence the patient's radiation exposure.
Both Q75 and Q50 precentiles are presented as KAP per kg for a variety of paediatric IC procedures. As all paedictric IC procedures,
on the island of Ireland,
are performed in a single hospital,
these values are proposed as national DRLs.
Personal information
Dara Murphy,
Radiology Department,
Our Lady's Children's Hospital,
Crumlin,
Dublin 12,
Ireland.
Siobhan McCoubrey,
Radiology Department,
Our Lady's Children's Hospital,
Crumlin,
Dublin 12,
Ireland.
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