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Ishibashi T, Takei Y, Kato M, Yamashita Y, Tsukamoto A, Matsumoto K, Sakamoto H, Masuda T, Miyazaki O. Patient dosimetry survey of pediatric diagnostic and therapeutic cardiac catheterisation in Japan. RADIATION PROTECTION DOSIMETRY 2023:7135728. [PMID: 37092251 DOI: 10.1093/rpd/ncad139] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/28/2022] [Accepted: 02/27/2023] [Indexed: 05/03/2023]
Abstract
To propose reference values for air-kerma at the reference point (Ka,r), air-kerma area product (PKA), fluoroscopy time (FT) and number of cine images (CI) for four age groups in Japan, a nationwide questionnaire was posted to 132 pediatric catheterisation of certified facility in Japan, using the conventional post system, to which 43 facilities responded. For diagnostic cardiac angiography, reference values were as follows: Ka,r: 86, 102, 165 and 264 mGy; PKA: 9.3, 9.5, 16 and 34 Gy.cm2; FT: 33, 29, 26 and 30 min and CI: 1904, 1966, 2405 and 1871 images. For therapeutic cardiac angiography, reference values were as follows: Ka,r: 107, 163, 103 and 202 mGy; PKA: 7.5, 18, 7 and 24 Gy.cm2; FT: 56, 52, 42 and 30 min and CI: 3886, 3232, 2212 and 4316 images for less than 1, 1-5, 6-10 and 11-15 y, respectively. To optimal patient exposure from diagnostic and therapeutic cardiac catheterisation, it is therefore necessary to establish reference values for pediatric cardiac catheterisation examinations for four age groups.
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Affiliation(s)
- Toru Ishibashi
- Department of Radiological Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima 730-8655, Japan
| | - Yasutaka Takei
- Department of Radiological Technology, Faculty of Health Science and Technology, School of Health Sciences, Ishikawa 920-0942, Japan
| | - Mamoru Kato
- Department of Radiology and Nuclear Medicine, Akita Cerebrospinal and Cardiovascular Center, Akita 010-0874, Japan
| | - Yukari Yamashita
- Department of Radiological Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima 730-8655, Japan
| | - Atsuko Tsukamoto
- Department of Radiology, NTT Medical Center Tokyo, Tokyo 141-8625, Japan
| | - Kazuma Matsumoto
- Department of Clinical Radiology, Hyogo College of Medicine College Hospital, Hyogo 663-8131, Japan
| | - Hajime Sakamoto
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, Tokyo 113-8421, Japan
| | - Takanori Masuda
- Department of Radiological Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima 730-8655, Japan
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development, Tokyo 157-1535, Japan
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Yagui A, Vosiak P, Schelin H, Denyak V, Filipov D, Paschuk S, Khoury H. Contribution of the fluoroscopy and cine modes to patient exposure in paediatric interventional cardiology procedures. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Karambatsakidou A, Steiner K, Fransson A, Poludniowski G. Age-specific and gender-specific radiation risks in paediatric angiography and interventional cardiology: conversion coefficients and risk reference values. Br J Radiol 2020; 93:20190869. [PMID: 32242740 PMCID: PMC10993205 DOI: 10.1259/bjr.20190869] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To estimate risk for exposure-induced cancer death (REID), organ-specific risks of exposure-induced cancer death (REIDHT) and associated conversion coefficients (CCREID:KAP=REID/kerma-area product (KAP), CCREIDHT:KAP=REIDHT/KAP) in paediatric cardiac catheterizations using data from radiation dose structured reports (RDSR). A novel risk surveillance tool consisting of age-specific and gender-specific risk reference values (RRVs) related to population cancer risk is suggested. METHODS The PCXMC v.2.0 code is used together with exposure-related information from RDSR from a cohort of 238 children to assess cancer risks and related conversion coefficients. The KAP corresponding to 1 in 1000 of increased REID is used to define age-specific and gender-specific KAP values to monitor risk in such patient cohorts, here denoted as RRVs. RESULTS The REID estimates ranged from below 1 up to 300 in 100,000, and the RRVs for the different age groups and gender ranged from 0.77 Gycm2 and 2.1 Gycm2 for neonates (female, male) to 11 Gycm2 and 25 Gycm2 for 15-year-olds (female, male). The CCREID:KAP and CCREIDHT:KAP decreased biexponentially with increased age, being notably higher for female patients. CONCLUSIONS Prominent risk contributing organs were the lungs and the (female) breast. The concept of age-specific and gender-specific RRVs related to population cancer risk is introduced and is intended to be used as a supporting tool for physicians performing such interventions. ADVANCES IN KNOWLEDGE Age-related and gender-related conversion coefficients for radiation risk, CCREID:KAP and CCREIDHT:KAP, are introduced and a novel risk surveillance concept, the RRV, is suggested for paediatric cardiac catheterizations.
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Affiliation(s)
- Angeliki Karambatsakidou
- Department of Medical Radiation Physics and Nuclear Medicine,
Karolinska University Hospital, 171 76
Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska
Institutet, 171 76 Stockholm,
Sweden
| | - Kristoffer Steiner
- Department of Women's and Children's Health, Karolinska
Institutet, 171 76 Stockholm,
Sweden
- Department of Paediatric Cardiology, Karolinska University
Hospital, Astrid Lindgrens Children´s Hospital
Solna, 171 76 Stockholm,
Sweden
| | - Annette Fransson
- Department of Medical Radiation Physics and Nuclear Medicine,
Karolinska University Hospital, 171 76
Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska
Institutet, 171 76 Stockholm,
Sweden
| | - Gavin Poludniowski
- Department of Medical Radiation Physics and Nuclear Medicine,
Karolinska University Hospital, 171 76
Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska
Institutet, 171 76 Stockholm,
Sweden
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Ubeda C, Vano E, Riquelme N, Aguirre D, Vasquez H, Chavez C, Dalmazzo D. Patient radiation doses in paediatric interventional cardiology and optimization actions. Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2019.108539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Stern H, Seidenbusch M, Hapfelmeier A, Meierhofer C, Naumann S, Schmid I, Spix C, Ewert P. Increased Cancer Incidence Following up to 15 Years after Cardiac Catheterization in Infants under One Year between 1980 and 1998-A Single Center Observational Study. J Clin Med 2020; 9:E315. [PMID: 31979109 PMCID: PMC7074298 DOI: 10.3390/jcm9020315] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 01/19/2020] [Accepted: 01/20/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the incidence of cancer within the first 15 years of life in children who underwent cardiac catheterization under the age of one year. METHODS In this retrospective, single center study, 2770 infants (7.8% with trisomy 21) were studied. All infants underwent cardiac catheterization under one year of age between January 1980 and December 1998. Newly diagnosed cancer in the first 15 years of life was assessed through record linkage to the German Childhood Cancer Registry (GCCR). Cancer risk in study patients was compared to the GCCR population of children less than 15 years. Patients with trisomy 21 were compared to the Danish Cytogenic Register for trisomy 21. Effective radiation doses were calculated for each tumor patient and 60 randomly selected patients who did not develop cancer. RESULTS In total, 24,472.5 person-years were analyzed. Sixteen children developed cancer, while 3.64 were expected (standardized incidence ratio (SIR) = 4.4, 95% confidence interval (CI): 2.5-7.2, p < 0.001). There was no preferred cancer type. The observed incidence of leukemia and solid tumors in trisomy 21 was only slightly higher (1 in 476 py) than expected (1 in 609 py, p = 0.64). There was no direct relationship between the radiation dose and the incidence of cancer. CONCLUSION Cardiac catherization in the first year of life was associated with a significantly increased cancer risk in a population with congenital heart disease.
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Affiliation(s)
- Heiko Stern
- German Heart Center Munich, Clinic for Pediatric Cardiology and Congenital Heart Disease, Lazarettstrasse 36, D-80636 Muenchen, Germany; (C.M.); (S.N.); (P.E.)
| | - Michael Seidenbusch
- German Research Center for Environmental Health, Institute of Radiation Protection, Ingolstaedter Landstrasse 1, D-85764 Neuherberg, Munich, Germany;
| | - Alexander Hapfelmeier
- Institute of Medical Informatics, Statistics and Epidemiology, Technical University Munich, Grillparzerstr. 18, Alexander Hapfelmeier, D-81675 Muenchen, Germany;
| | - Christian Meierhofer
- German Heart Center Munich, Clinic for Pediatric Cardiology and Congenital Heart Disease, Lazarettstrasse 36, D-80636 Muenchen, Germany; (C.M.); (S.N.); (P.E.)
| | - Susanne Naumann
- German Heart Center Munich, Clinic for Pediatric Cardiology and Congenital Heart Disease, Lazarettstrasse 36, D-80636 Muenchen, Germany; (C.M.); (S.N.); (P.E.)
| | - Irene Schmid
- Department of Pediatric Oncology and Hematology, Dr. von Hauner Childrens Hospital, Ludwig-Maximilians-University of Munich, Lindwurmstrasse 4, 80337 Muenchen, Germany;
| | - Claudia Spix
- German Childhood Cancer Registry (GCCR), Institute for Medical Biostatistics, Epidemiology and Informatics, Johannes Gutenberg-University, Obere Zahlbacher Strasse 69, 55131 Mainz, Germany;
| | - Peter Ewert
- German Heart Center Munich, Clinic for Pediatric Cardiology and Congenital Heart Disease, Lazarettstrasse 36, D-80636 Muenchen, Germany; (C.M.); (S.N.); (P.E.)
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Rana BS, Kumar S, Sandhu IS, Singh NP. DOSIMETRY OF ADULT AND PEDIATRIC PATIENTS FOR COMMON DIGITAL RADIOGRAPHY EXAMINATIONS. RADIATION PROTECTION DOSIMETRY 2018; 179:349-357. [PMID: 29342278 DOI: 10.1093/rpd/ncx293] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 12/02/2017] [Indexed: 06/07/2023]
Abstract
The present work reports dosimetry data on adult and pediatric patients for some common radiographic examinations during the standard hospital routine. The measurements are the part of quality assurance program to determine radiation exposures to patients in these examinations. The entrance skin doses (ESDs) of the patients were measured from 2451 projection for 12 diagnostic examinations in digital radiography (DR). The ESDs in adult patient were measured using thermoluminescence dosemeters placed on the skin of the patient. In pediatric patients, ESDs were evaluated from the measured air kerma with ionization chamber, patient specific parameters and known values of machine exposure factors during examinations. The third quartile values of ESDs are proposed as local diagnostic reference levels (LDRLs) for radiographic examinations having statistical significant number of exposures (n ≥ 20). The proposed LDRL values are also compared with earlier published LDRL/DRL values.
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Affiliation(s)
| | - Sanjeev Kumar
- Department of Physics, G.G.D.S.D. College, Chandigarh, India
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Ubeda C, Vano E, Salazar L, Santos F, Gutierrez R, Manterola C. Paediatric interventional cardiology in Costa Rica: diagnostic reference levels and estimation of population dose. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2018; 38:218-228. [PMID: 29160230 DOI: 10.1088/1361-6498/aa9c09] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The goal of the present study was to propose a set of national diagnostic reference levels (DRLs) in Costa Rica for paediatric interventional cardiology (IC) procedures classified by age and weight and to estimate the collective dose of the paediatric population from these intervention practices. The data collection period was May 2016 to May 2017. The third quartile of patient dose data distributions for kerma-area product (KAP) values was set as the national DRLs. A sample of 154 paediatric IC procedures (collected in the national paediatric hospital with a single x-ray system) was used and divided into four age ranges and five weight ranges. The national DRLs obtained for KAPs by age range were 1.79 Gy cm2 (<1 year) to 23.0 Gy cm2 (10-15 years). The national DRLs obtained for KAPs by weight range were 1.0 Gy cm2 (<10 kg) to 49.6 Gy cm2 (50-79 kg). The contribution to the collective dose of the population of Costa Rica amounted to 0.78 person Sv.
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Affiliation(s)
- C Ubeda
- Departamento de Tecnología Médica, Facultad de Ciencias de la Salud, Universidad de Tarapacá, Arica, Chile
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Gould R, McFadden SL, Hughes CM. Radiation dose in paediatric cardiac catheterisation: A systematic literature review. Radiography (Lond) 2017; 23:358-364. [PMID: 28965901 DOI: 10.1016/j.radi.2017.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 02/01/2017] [Accepted: 02/03/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVES It is believed that children are more sensitive to ionising radiation than adults. This work reviewed the reported radiation dose estimates for paediatric cardiac catheterisation. A systematic literature review was performed by searching healthcare databases for studies reporting radiation dose using predetermined key words relating to children having cardiac catheterisation. The quality of publications was assessed using relevant Critical Appraisal Skills Programme questions and their reported radiation exposures were evaluated. KEY FINDINGS It is only in recent years that larger cohort observations have been undertaken. Although radiation dose from paediatric cardiac catheterisation has decreased in recent years, the literature indicated that it remains varied and potentially substantial. CONCLUSION Standardisation of weight categories and procedure types such as those recommended by the PiDRL project could help compare current and future radiation dose estimates.
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Affiliation(s)
- R Gould
- Institute of Nursing and Health Research, Ulster University, Jordanstown Campus, Shore Road, Newtownabbey, BT37 OQB, United Kingdom.
| | - S L McFadden
- Institute of Nursing and Health Research, Ulster University, Jordanstown Campus, Shore Road, Newtownabbey, BT37 OQB, United Kingdom
| | - C M Hughes
- Institute of Nursing and Health Research, Ulster University, Jordanstown Campus, Shore Road, Newtownabbey, BT37 OQB, United Kingdom
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Ahmed NA, Nayel AI. PEDIATRIC RADIATION DOSE DURING CARDIAC CATHETERIZATION PROCEDURES IN SUDAN. RADIATION PROTECTION DOSIMETRY 2017; 174:495-500. [PMID: 27522052 DOI: 10.1093/rpd/ncw222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 07/01/2016] [Indexed: 06/06/2023]
Abstract
Children are more radio sensitive than adult. This study aims to assess radiation doses and the associated hazards to pediatric during cardiac catheterization procedures. Radiation dose for 112 patients was estimated in the biggest cardiac center in Sudan. The median KAP in Gy cm2, CK in mGy, number of frames and fluoroscopy time in minutes were (4.6, 29.0, 340.4, 13.5) and (6.0, 35.0, 318, 9.8) for the diagnostic and therapeutic cardiac procedures, respectively. The median (KAP in Gy cm2, effective dose in mSv) for different age groups in the intervals of less than 1 year, 1-<5 years, 5-<10 years and 10-15 years old were (2.2, 4.4), (2.5, 5.0), (4.2, 5.1) and (8.5, 4.1) respectively. Including all the procedures using the multiplicative model of ICRP 60, the mean attributable lifetime risk for stochastic effect was 0.08 and 0.05% for girls and boys, respectively. Training is needed to raise staff awareness about radiation protection.
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Affiliation(s)
- Nada A Ahmed
- Radiation Safety Institute, Sudan Atomic Energy Commission, Khartoum, P.O. Box 3001, Sudan
| | - A I Nayel
- Radiation Safety Institute, Sudan Atomic Energy Commission, Khartoum, P.O. Box 3001, Sudan
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Ubeda C, Miranda P, Vano E. Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values. Med Phys 2015; 42:615-622. [PMID: 25771560 DOI: 10.1118/1.4905116] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 11/11/2014] [Accepted: 12/14/2014] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency. METHODS Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs. RESULTS Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for <1 yr; 213 for 1 to <5 yr; 82 for 5 to <10 yr; and 102 for 10 to <16 yr. The third quartile values obtained for DAP by diagnostic and therapeutic procedures and age range were 1.17 and 1.11 Gy cm2 for <1 yr; 1.74 and 1.90 Gy cm2 for 1 to <5 yr; 2.83 and 3.22 Gy cm2 for 5 to <10 yr; and 7.34 and 8.68 Gy cm2 for 10 to <16 yr, respectively. The third quartile value obtained for the DAP/body weight ratio for the full sample of procedures was 0.17 (Gy cm2/kg) for diagnostic and therapeutic procedures. CONCLUSIONS The data presented in this paper are an initial attempt at establishing local DRLs in pediatric interventional cardiology, from a large sample of procedures for the standard age bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there may be large differences in child size. These DRLs were obtained at the largest pediatric hospital in Chile, with an active optimization program, and could be used by other hospitals in the Latin America region to compare their current patient dose values and determine whether corrective action is appropriate.
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Mauriello DA, Fetterly KA, Lennon RJ, Reeder GS, Taggart NW, Hagler DJ, Cetta F, Cabalka AK. Radiation reduction in pediatric and adult congenital patients during cardiac catheterization. Catheter Cardiovasc Interv 2014; 84:801-8. [PMID: 24782364 DOI: 10.1002/ccd.25533] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 04/16/2014] [Accepted: 04/27/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Our objective was to determine if technical changes combined with radiation safety initiatives reduced the radiation dose delivered to patients during congenital catheterization. BACKGROUND Use of ionizing radiation is necessary during cardiac catheterization. Minimizing radiation dose, while maintaining clinically useful image quality, is an important safety issue. In our congenital heart center intentional practice changes, including technical changes and provider awareness initiatives, were implemented to decrease radiation dose. METHODS Data were retrospectively collected for all procedures involving children and adults with congenital heart disease (CHD) undergoing catheterization over 45 months. Cases were divided into three categories including: noninterventional (NI), simple intervention (SI), and complex intervention (CI). The change in dose was modeled as log of cumulative air kerma (Ka,r ). The change in Ka,r was evaluated for each procedural category as well as changes occurring as a function of age and weight. RESULTS Considering all procedures (n = 1,082), Ka,r decreased by 61%. In the NI group (n = 481), Ka,r decreased by 71%. In the SI group (n = 424), Ka,r decreased by 74%. The Ka,r for the 10-17 year old group (n = 125) and those ≥18 years (n = 709) decreased 74 and 67%, respectively. The Ka,r decreased 72 and 66% for those 20-60 kg and ≥60 kg, respectively. Groups not showing significant change in Ka,r included CI, age ≤9 years, and weight ≤20 kg. CONCLUSIONS Through technical changes and provider awareness initiatives, our institution dramatically reduced the radiation dose in the majority of pediatric and adult CHD patients undergoing cardiac catheterization.
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The establishment of local diagnostic reference levels for paediatric interventional cardiology. Radiography (Lond) 2013. [DOI: 10.1016/j.radi.2013.04.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Baysson H, Réhel JL, Boudjemline Y, Petit J, Girodon B, Aubert B, Laurier D, Bonnet D, Bernier MO. Risk of cancer associated with cardiac catheterization procedures during childhood: a cohort study in France. BMC Public Health 2013; 13:266. [PMID: 23521893 PMCID: PMC3621730 DOI: 10.1186/1471-2458-13-266] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 03/08/2013] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Radiation can be used effectively for diagnosis and medical treatment, but it can also cause cancers later on. Children with congenital heart disease frequently undergo cardiac catheterization procedures for diagnostic or treatment purposes. Despite the clear clinical benefit to the patient, the complexity of these procedures may result in high cumulative radiation exposure. Given children's greater sensitivity to radiation and the longer life span during which radiation health effects can develop, an epidemiological cohort study is being launched in France to evaluate the risks of leukaemia and solid cancers in this specific population. METHODS/DESIGN The study population will include all children who have undergone at least one cardiac catheterization procedure since 2000 and were under 10 years old and permanent residents of France at the time of the procedure. Electronically stored patient records from the departments of paediatric cardiology of the French national network for complex congenital heart diseases (M3C) are being searched to identify the children to be included. The minimum dataset will comprise: identification of the subject (file number in the centre or department, full name, sex, date and place of birth), and characteristics of the intervention (date, underlying disease, type of procedure, technical details, such as fluoroscopy time and dose area product, (DAP), which are needed to reconstruct the doses received by each child). The cohort will be followed up through linkage with the two French paediatric cancer registries, which have recorded all cases of childhood leukaemia and solid cancers in France since 1990 and 2000, respectively. Radiation exposure will be estimated retrospectively for each child. 4500 children with catherizations between 2000 and 2011 have been already included in the cohort, and recruitment is ongoing at the national level. The study is expected to finally include a total of 8000 children. DISCUSSION This French cohort study is specifically designed to provide further knowledge about the potential cancer risks associated with paediatric cardiac catheterization procedures. It will also provide new information on typical dose levels associated with these procedures in France. Finally, it should help improve awareness of the importance of radiation protection in these procedures.
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Affiliation(s)
- Helene Baysson
- Institut de Radioprotection et de Sûreté Nucléaire, PRP-HOM, SRBE, BP 17, Fontenay aux Roses, France
| | - Jean Luc Réhel
- Institut de Radioprotection et de Sûreté Nucléaire, PRP-HOM, SRBE, BP 17, Fontenay aux Roses, France
| | - Younes Boudjemline
- Centre de Référence Malformations Cardiaques Congénitales Complexes, M3C, Hôpital Necker-Enfants malades, AP-HP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jerôme Petit
- Centre de Référence Malformations Cardiaques Congénitales Complexes, M3C, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Brigitte Girodon
- Centre de Référence Malformations Cardiaques Congénitales Complexes, M3C, Hôpital Necker-Enfants malades, AP-HP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Bernard Aubert
- Institut de Radioprotection et de Sûreté Nucléaire, PRP-HOM, SRBE, BP 17, Fontenay aux Roses, France
| | - Dominique Laurier
- Institut de Radioprotection et de Sûreté Nucléaire, PRP-HOM, SRBE, BP 17, Fontenay aux Roses, France
| | - Damien Bonnet
- Centre de Référence Malformations Cardiaques Congénitales Complexes, M3C, Hôpital Necker-Enfants malades, AP-HP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Marie-Odile Bernier
- Institut de Radioprotection et de Sûreté Nucléaire, PRP-HOM, SRBE, BP 17, Fontenay aux Roses, France
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Navarro VCC, Navarro MVT, Maia AF, Oliveira ADD, Oliveira ADSP. Avaliação de exposições médicas em procedimentos pediátricos de radiologia intervencionista. Radiol Bras 2012. [DOI: 10.1590/s0100-39842012000400006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Avaliar as exposições pediátricas de radiologia intervencionista em dois hospitais do Estado da Bahia, visando contribuir para a construção de um cenário estadual e nacional, possibilitando o conhecimento das exposições e da necessidade de sua otimização, visto que as peculiaridades que envolvem a radiologia e a pediatria se potencializam quando se trata de procedimentos de radiologia intervencionista, em razão das doses elevadas de radiação. MATERIAIS E MÉTODOS: Foram avaliados 32 procedimentos em quatro salas nos dois principais hospitais que realizam procedimentos de radiologia intervencionista pediátrica na Bahia. Foram avaliados os valores de kerma no ar incidente e o produto kerma-área no ar de 27 procedimentos cardiológicos e 5 procedimentos cerebrais. RESULTADOS: Os valores máximos de produto kerma-área e kerma obtidos para procedimentos cardiológicos foram, respectivamente, 129,9 Gy.cm² e 947,0 mGy, e para procedimentos cerebrais, 83,3 Gy.cm² e 961,0 mGy. CONCLUSÃO: Os resultados deste estudo mostraram valores de exposições superiores em até 14 vezes os obtidos em estudos realizados em outros países, chegando próximos de resultados obtidos para procedimentos em adultos. Isto revela quão elevadas podem ser as exposições pediátricas, indicando a necessidade de constante otimização dos procedimentos e avaliação das exposições.
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Ubeda C, Vano E, Miranda P, Leyton F. Pilot program on patient dosimetry in pediatric interventional cardiology in Chile. Med Phys 2012; 39:2424-30. [DOI: 10.1118/1.3702590] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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