Abstract 20230: Radiation Exposure from Diagnostic and Interventional Cases in a Modern, Large-volume Pediatric Cardiac Catheterization Laboratory
Introduction: Radiation exposure from pediatric cardiac catheterization may be substantial, although published estimates are based on small samples. We aim to report radiation dose across a range of diagnostic and interventional cases in a modern, high-volume pediatric laboratory.
Hypothesis: Radiation dose from diagnostic and interventional pediatric cardiac catheterization cases will be varied, and at times substantial. We expect important differences in dose based on case type.
Methods: We retrospectively reviewed diagnostic and interventional cases performed in our pediatric cardiac catheterization laboratory from April, 2009 - April, 2010 for which radiation usage data were available as reported by the Artis zee® (Siemens Medical Solutions) system. Electrophysiology cases are excluded. Radiation dose was quantified as skin entrance dose (mGy) and dose area product (DAP, μGy·m2). The DAP was converted to an effective dose (mSv) using the Monte Carlo method.
Results: Radiation usage data were available from 898 diagnostic and interventional cases with an overall median skin entrance dose of 149.5 mGy (IQR: 65.2-449.4), median DAP of 918.8 μGy·m2 (IQR: 323.8-2794.2), and median effective dose of 6.4 mSv (IQR: 2.9-14.2). There was a significant difference in all measures of radiation dose based on procedural (p=0.0001) and interventional type (p=0.0001), summarized in Table 1. Patient weight, age, and total fluoroscopy time were independent predictors of all measures of radiation exposure (p<0.001, using log-transformed radiation outcome variables).
Conclusion: Across a large number and range of pediatric interventional and diagnostic cardiac catheterization cases, the median effective dose is 6.4 mSv. There is a wide range of exposure doses, with outliers receiving substantial radiation exposure. We conclude that radiation monitoring is an important component of a cardiac catheterization laboratory and dose reduction strategies are warranted.
- © 2010 by American Heart Association, Inc.