Patient doses from fluoroscopically guided cardiac procedures in pediatrics
Infants and children are a higher risk population for radiation cancer induction compared to adults. Although some values on pediatric patient doses for cardiac procedures have been reported, data to determine reference levels are scarce, especially when compared to those available for adults in dia...
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| Veröffentlicht in: | Physics in medicine & biology 2007-08, Vol.52 (16), p.4749-4759 |
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| creator | Martinez, L C Vano, E Gutierrez, F Rodriguez, C Gilarranz, R Manzanas, M J |
| description | Infants and children are a higher risk population for radiation cancer induction compared to adults. Although some values on pediatric patient doses for cardiac procedures have been reported, data to determine reference levels are scarce, especially when compared to those available for adults in diagnostic and therapeutic procedures. The aim of this study is to make a new contribution to the scarce published data in pediatric cardiac procedures and help in the determination of future dose reference levels. This paper presents a set of patient dose values, in terms of air kerma area product (KAP) and entrance surface air kerma (ESAK), measured in a pediatric cardiac catheterization laboratory equipped with a biplane x-ray system with dynamic flat panel detectors. Cardiologists were properly trained in radiation protection. The study includes 137 patients aged between 10 days and 16 years who underwent diagnostic catheterizations or therapeutic procedures. Demographic data and technical details of the procedures were also gathered. The x-ray system was submitted to a quality control programme, including the calibration of the transmission ionization chamber. The age distribution of the patients was 47 for |
| doi_str_mv | 10.1088/0031-9155/52/16/003 |
| format | Article |
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Although some values on pediatric patient doses for cardiac procedures have been reported, data to determine reference levels are scarce, especially when compared to those available for adults in diagnostic and therapeutic procedures. The aim of this study is to make a new contribution to the scarce published data in pediatric cardiac procedures and help in the determination of future dose reference levels. This paper presents a set of patient dose values, in terms of air kerma area product (KAP) and entrance surface air kerma (ESAK), measured in a pediatric cardiac catheterization laboratory equipped with a biplane x-ray system with dynamic flat panel detectors. Cardiologists were properly trained in radiation protection. The study includes 137 patients aged between 10 days and 16 years who underwent diagnostic catheterizations or therapeutic procedures. Demographic data and technical details of the procedures were also gathered. The x-ray system was submitted to a quality control programme, including the calibration of the transmission ionization chamber. The age distribution of the patients was 47 for <1 year; 52 for 1-<5 years; 25 for 5-<10 years and 13 for 10-<16 years. Median values of KAP were 1.9, 2.9, 4.5 and 15.4 Gy cm(2) respectively for the four age bands. These KAP values increase by a factor of 8 when moving through the four age bands. The probability of a fatal cancer per fluoroscopically guided cardiac procedure is about 0.07%. Median values of ESAK for the four age bands were 46, 50, 56 and 163 mGy, which lie far below the threshold for deterministic effects on the skin. These dose values are lower than those published in previous papers.</description><identifier>ISSN: 0031-9155</identifier><identifier>EISSN: 1361-6560</identifier><identifier>DOI: 10.1088/0031-9155/52/16/003</identifier><identifier>PMID: 17671333</identifier><language>eng</language><publisher>England: IOP Publishing</publisher><subject>Adolescent ; Body Burden ; Cardiovascular Surgical Procedures - statistics & numerical data ; Child ; Female ; Fluoroscopy - mortality ; Humans ; Incidence ; Infant ; Infant, Newborn ; Italy - epidemiology ; Male ; Neoplasms, Radiation-Induced - mortality ; Pediatrics - statistics & numerical data ; Relative Biological Effectiveness ; Risk Assessment - methods ; Risk Factors ; Skin Neoplasms - mortality ; Surgery, Computer-Assisted - statistics & numerical data ; Survival Analysis ; Whole-Body Counting - statistics & numerical data</subject><ispartof>Physics in medicine & biology, 2007-08, Vol.52 (16), p.4749-4759</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c377t-8a45483d49ee936d4d46d1d0d83f6e23b1a7266e2b22e28d89fea9bf98029c783</citedby><cites>FETCH-LOGICAL-c377t-8a45483d49ee936d4d46d1d0d83f6e23b1a7266e2b22e28d89fea9bf98029c783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://iopscience.iop.org/article/10.1088/0031-9155/52/16/003/pdf$$EPDF$$P50$$Giop$$H</linktopdf><link.rule.ids>314,776,780,27903,27904,53808,53888</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17671333$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martinez, L C</creatorcontrib><creatorcontrib>Vano, E</creatorcontrib><creatorcontrib>Gutierrez, F</creatorcontrib><creatorcontrib>Rodriguez, C</creatorcontrib><creatorcontrib>Gilarranz, R</creatorcontrib><creatorcontrib>Manzanas, M J</creatorcontrib><title>Patient doses from fluoroscopically guided cardiac procedures in pediatrics</title><title>Physics in medicine & biology</title><addtitle>Phys Med Biol</addtitle><description>Infants and children are a higher risk population for radiation cancer induction compared to adults. Although some values on pediatric patient doses for cardiac procedures have been reported, data to determine reference levels are scarce, especially when compared to those available for adults in diagnostic and therapeutic procedures. The aim of this study is to make a new contribution to the scarce published data in pediatric cardiac procedures and help in the determination of future dose reference levels. This paper presents a set of patient dose values, in terms of air kerma area product (KAP) and entrance surface air kerma (ESAK), measured in a pediatric cardiac catheterization laboratory equipped with a biplane x-ray system with dynamic flat panel detectors. Cardiologists were properly trained in radiation protection. The study includes 137 patients aged between 10 days and 16 years who underwent diagnostic catheterizations or therapeutic procedures. Demographic data and technical details of the procedures were also gathered. The x-ray system was submitted to a quality control programme, including the calibration of the transmission ionization chamber. The age distribution of the patients was 47 for <1 year; 52 for 1-<5 years; 25 for 5-<10 years and 13 for 10-<16 years. Median values of KAP were 1.9, 2.9, 4.5 and 15.4 Gy cm(2) respectively for the four age bands. These KAP values increase by a factor of 8 when moving through the four age bands. The probability of a fatal cancer per fluoroscopically guided cardiac procedure is about 0.07%. Median values of ESAK for the four age bands were 46, 50, 56 and 163 mGy, which lie far below the threshold for deterministic effects on the skin. These dose values are lower than those published in previous papers.</description><subject>Adolescent</subject><subject>Body Burden</subject><subject>Cardiovascular Surgical Procedures - statistics & numerical data</subject><subject>Child</subject><subject>Female</subject><subject>Fluoroscopy - mortality</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Italy - epidemiology</subject><subject>Male</subject><subject>Neoplasms, Radiation-Induced - mortality</subject><subject>Pediatrics - statistics & numerical data</subject><subject>Relative Biological Effectiveness</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Skin Neoplasms - mortality</subject><subject>Surgery, Computer-Assisted - statistics & numerical data</subject><subject>Survival Analysis</subject><subject>Whole-Body Counting - statistics & numerical data</subject><issn>0031-9155</issn><issn>1361-6560</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1LxDAQhoMo7rr6CwTJWehuJmnT5CiLX7igBz2HNB8S6W5K0h7239uyogc9eJp5h-d9mRmELoEsgQixIoRBIaGqVhVdAZ_0EZoD41DwipNjNP8mZugs5w9CAAQtT9EMal4DY2yOnl50H9yuxzZml7FPcYt9O8QUs4ldMLpt9_h9CNZZbHSyQRvcpWicHdLIhx3u3DjsUzD5HJ143WZ38VUX6O3u9nX9UGye7x_XN5vCsLruC6HLqhTMltI5ybgtbcktWGIF89xR1oCuKR-7hlJHhRXSOy0bLwWh0tSCLRA75Jpxy5ycV10KW532CoiaXqOmw9V0uKqoAj7p0XV1cHVDs3X2x_P1ixFYHoAQu38mXv82_AGqznr2CcaTekQ</recordid><startdate>20070821</startdate><enddate>20070821</enddate><creator>Martinez, L C</creator><creator>Vano, E</creator><creator>Gutierrez, F</creator><creator>Rodriguez, C</creator><creator>Gilarranz, R</creator><creator>Manzanas, M J</creator><general>IOP Publishing</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20070821</creationdate><title>Patient doses from fluoroscopically guided cardiac procedures in pediatrics</title><author>Martinez, L C ; Vano, E ; Gutierrez, F ; Rodriguez, C ; Gilarranz, R ; Manzanas, M J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c377t-8a45483d49ee936d4d46d1d0d83f6e23b1a7266e2b22e28d89fea9bf98029c783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adolescent</topic><topic>Body Burden</topic><topic>Cardiovascular Surgical Procedures - statistics & numerical data</topic><topic>Child</topic><topic>Female</topic><topic>Fluoroscopy - mortality</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Italy - epidemiology</topic><topic>Male</topic><topic>Neoplasms, Radiation-Induced - mortality</topic><topic>Pediatrics - statistics & numerical data</topic><topic>Relative Biological Effectiveness</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Skin Neoplasms - mortality</topic><topic>Surgery, Computer-Assisted - statistics & numerical data</topic><topic>Survival Analysis</topic><topic>Whole-Body Counting - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martinez, L C</creatorcontrib><creatorcontrib>Vano, E</creatorcontrib><creatorcontrib>Gutierrez, F</creatorcontrib><creatorcontrib>Rodriguez, C</creatorcontrib><creatorcontrib>Gilarranz, R</creatorcontrib><creatorcontrib>Manzanas, M J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Physics in medicine & biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martinez, L C</au><au>Vano, E</au><au>Gutierrez, F</au><au>Rodriguez, C</au><au>Gilarranz, R</au><au>Manzanas, M J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient doses from fluoroscopically guided cardiac procedures in pediatrics</atitle><jtitle>Physics in medicine & biology</jtitle><addtitle>Phys Med Biol</addtitle><date>2007-08-21</date><risdate>2007</risdate><volume>52</volume><issue>16</issue><spage>4749</spage><epage>4759</epage><pages>4749-4759</pages><issn>0031-9155</issn><eissn>1361-6560</eissn><abstract>Infants and children are a higher risk population for radiation cancer induction compared to adults. Although some values on pediatric patient doses for cardiac procedures have been reported, data to determine reference levels are scarce, especially when compared to those available for adults in diagnostic and therapeutic procedures. The aim of this study is to make a new contribution to the scarce published data in pediatric cardiac procedures and help in the determination of future dose reference levels. This paper presents a set of patient dose values, in terms of air kerma area product (KAP) and entrance surface air kerma (ESAK), measured in a pediatric cardiac catheterization laboratory equipped with a biplane x-ray system with dynamic flat panel detectors. Cardiologists were properly trained in radiation protection. The study includes 137 patients aged between 10 days and 16 years who underwent diagnostic catheterizations or therapeutic procedures. Demographic data and technical details of the procedures were also gathered. The x-ray system was submitted to a quality control programme, including the calibration of the transmission ionization chamber. The age distribution of the patients was 47 for <1 year; 52 for 1-<5 years; 25 for 5-<10 years and 13 for 10-<16 years. Median values of KAP were 1.9, 2.9, 4.5 and 15.4 Gy cm(2) respectively for the four age bands. These KAP values increase by a factor of 8 when moving through the four age bands. The probability of a fatal cancer per fluoroscopically guided cardiac procedure is about 0.07%. Median values of ESAK for the four age bands were 46, 50, 56 and 163 mGy, which lie far below the threshold for deterministic effects on the skin. These dose values are lower than those published in previous papers.</abstract><cop>England</cop><pub>IOP Publishing</pub><pmid>17671333</pmid><doi>10.1088/0031-9155/52/16/003</doi><tpages>11</tpages></addata></record> |
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| subjects | Adolescent Body Burden Cardiovascular Surgical Procedures - statistics & numerical data Child Female Fluoroscopy - mortality Humans Incidence Infant Infant, Newborn Italy - epidemiology Male Neoplasms, Radiation-Induced - mortality Pediatrics - statistics & numerical data Relative Biological Effectiveness Risk Assessment - methods Risk Factors Skin Neoplasms - mortality Surgery, Computer-Assisted - statistics & numerical data Survival Analysis Whole-Body Counting - statistics & numerical data |
| title | Patient doses from fluoroscopically guided cardiac procedures in pediatrics |
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