Abstract 12375: Radiation Exposure and Estimated Lifetime Attributable Risk of Cancer From Cardiac Catheterization in Children
Background: Children are particularly sensitive to the potentially carcinogenic effects of ionizing radiation. Yet, limited data exist in children on relative radiation exposure and lifetime attributable risk (LAR) of cancer from cardiac catheterization. We measured organ specific effective dose (ED) in millisieverts (mSv) from fluoroscopy and estimated LAR of cancer for various cardiac catheterization exposures.
Methods: Dosimeters were placed over 17 vital tissue structures in two anthropometric phantoms sized to approximate a 1 and a 5 year-old child. ED was measured for 8 conventional fluoroscopic and cineangiographic projections using solid-state detectors. These data were used to calculate ED for low, moderate and high exposure catheterizations (fluoroscopy time/# biplane cineangiograms: 10min/n=2, 20min/n=4, 50min/n=8, respectively). Exposure estimates were validated in 200 consecutive catheterizations in children ≤ 6 years of age and compared to published data for other imaging modalities. LAR of cancer was estimated using the methods of the 7th Committee on Biological Effects of Ionizing Radiation (BEIR VII).
Results: ED for a 4 second biplane cineangiogram and 5 minutes of AP fluoroscopy were 0.5-1.2 and 1.8-2.1 mSv respectively, depending on phantom size and camera angle. EDs for a single simulated low, moderate and high exposure catheterization in a 5 year-old child were 4.5, 9.2 and 21.9 mSv respectively (figure1a) and were consistent with the range of calculated institutional exposures (median ED: 12.0 mSv, 10-90%: 5.2-25.4 mSv). Associated LAR of cancer for a single simulated catheterization was 0.1-0.5% for males and 0.2-0.9% for females depending on exposure (figure1b).
Conclusion: Estimated radiation dose and resultant LAR of cancer for cardiac catheterization can be substantial. Quality improvement initiatives should focus on minimizing radiation exposure, in all children, but with a potentially greater impact on risk in females.
- © 2013 by American Heart Association, Inc.