EuroSafe Imaging 2020
Action 7 - Radiation protection of children, Paediatric, Fluoroscopy, Diagnostic procedure, Dosimetric comparison, Retrospective, Diagnostic or prognostic study, Performed at one institution
B. S. POTTY, J. S. AlSuwaidi, A. S. Bayazed, A. A. Alshizawi
Description of activity and work performed
Latifa Women and Children’s Hospital (LWCH) being the Paediatric Hospital for DHA is monitoring fluoroscopy dose since 10 years. The summary of DHA dose journey is:
2009-2014: International Atomic Energy Agency (IAEA) Technical Cooperation (TC) Project forms were used to collect dose data for fluoroscopy with external DAP meter and Diameter dose reading devices, which required the operators’ input, such as patient weight, height and age to get the DAP values and entrance dose for each patient.
2015-2017: The digital fluoroscopy system implemented, which has an inbuilt DAP meter. It records each patient’s dose automatically and provides the doses in a single capture record. The radiographers receive immediate and direct feedback related to the patient’s exposure. The fluoroscopy system sends each patient’s exam protocol along with the images to PACS (Picture Archiving and Communication System), which contains dose details and exposure parameters. A retrospective data analysis from Radiology Information System (RIS)/PACS for all paediatric patients over a period of two years was included in this study. In DHA, paediatric age is upto 13years, while ICRP & other International standard used paediatric age up to 15years. Population size is categorized according to the published international standard age as 0-1m (new born), >1m-<1yr, 1yr, >1-5yrs, >5-10yrs and >10-13yrs [3-9].The common fluoroscopic investigations in LWCH are Micturition Cysto Urethrography (MCUG), Contrast (barium or water-soluble) Swallow, Contrast Meal and Contrast Enema. The minimum sample size for each age group was ten cases and the third quartile dose values were used to establish local DRLs [8-9] (Table 1).The sample collection for cortrast enema for paediatric age group 10-13yrs was insufficient because of less practice in LWCH.
2017-2019: Patient dose data collected as per the ICRP -135 standard , LWCH typical dose values obtained from the median value (Table 2 & Figure 1).
2019: The new software “DOSE” by Qaelum introduced in DHA, which collects and analyses dose data from all radiation modalities with information on patient age and weight.
LWCH implemented Contrast Enhanced Voiding Urosonography, Sonographic meal and Sonographic Enema as effective non-ionization diagnostic tools to replace some fluoroscopic procedures.Based on the retrospective data collected from RIS/PACS (2017-2019), 21.4% of fluoroscopic procedures were replaced by sonography (Figure 2).