Abstract 20594: Variation of Radiation Usage and Current Practice in the Pediatric Cardiac Catheterization Laboratory - A Multicenter Study by the CCISC (Congenital Cardiovascular Interventional Study Consortium)
Introduction: Reduction of radiation dosage is an important task of quality improvement in pediatric cardiac catheterization laboratories. Comparison of data with a benchmark allows intra and inter-institutional comparisons to be made. To date, institutional variation of catheterization practices focusing on radiation dosage has not been well described.
Hypothesis: We hypothesized that radiation dosage significantly vary between institutions and there may be significant effect of frame rate on radiation dosage.
Methods: This was a multicenter observational study of children undergoing catheterizations in pediatric laboratories. Utilizing normalized air Kerma area product (PKA) by body weight (PKA/BW, μGym2/kg) as a standardized measure, institutional variation and trend of radiation dosage from 2009 to 2013 were analyzed. Cases were broken down into interventional, diagnostic, and transplant right ventricular transplant biopsy. These cases were further categorized into high (30 frame/sec for cine and 15 for fluoroscopy) and low (15 and 7.5, respectively) frame rate groups and the effect of frame rate on radiation dosage was assessed.
Results: Among 8267 procedures from 16 institutions, PKA/BW was significantly variable between institutions (p<0.001). There was a gradual decrease in the annual median PKA/BW of diagnostic and interventional procedures over 5 years, despite no significant change in fluoroscopic time. High frame rate group had significantly higher PKA/BW (p<0.001) in diagnostic and interventional catheterizations.
Conclusions: PKA/BW appeared to be a useful standardized measure of radiation dose to compare between institutions. Significant variation of radiation dosage suggests a need of quality control in this field. Use of lower frame rates significantly lowered radiation dosages for similar procedural types. A concerted effort should be made to lower the frame rates in labs with consistently higher radiation usage.
Author Disclosures: D. Kobayashi: None. T.J. Forbes: None.
- © 2014 by American Heart Association, Inc.