A pilot programme on patient dosimetry on paediatric interventional cardiology in Chile

摘要

in paediatric interventional cardiology (PIC) in Chile. The collected parameters during the survey have been:procedure identification, patient age, gender, weight, height, kerma area product (Pka), cumulative dose at theinterventional reference point, number of cine series, total number of frames and fluoroscopy time. These datawill also permit the estimation of typical radiological risks of the procedures for different age groups.Preliminary results are being calculated for the following age groups: <1; 1- <5; 5- <10 and 10- <16 years.Kerma area product values and parameters related to imaging protocols of the procedures have been initiallyobtained from one of the most representative paediatrics centres of Chile. The x-ray system used in this centrewas a biplane Siemens Axiom Artis with image intensifiers. The sample contains patients aged between 6 daysand < 16 years. The patient distribution for the different age groups was 68 for <1 year; 95 for 1- <5 years; 37 for5-< 10 years and 59 for 10-<16 years. Median values of Pka for diagnostic procedures were: 1.0; 1.6; 2.0 and 4.9Gy.cm~2 respectively, and for therapeutic ones: 1.1; 1.3; 1.4 and 5.8 Gy.cm2 respectively. No significant statisticaldifferences were found between diagnostic and therapeutic groups. Results are similar (slightly lower) to otherrecent published values in Europe, suggesting that an approach to propose patient dose reference levels couldalso be advisable in paediatric cardiology. Dependence of air kerma area product on patient weight is, asexpected, stronger for P_(KA) per minute fluoroscopy and per acquisition frame on patient weight than thedependence for the whole procedure, due to the influence of procedure complexity. Nevertheless, influence ofpatient weight on air kerma area product becomes plausible, even for the whole procedure, by appropriate datarepresentation. Suggestions to optimize the practice of paediatric cardiology are concluded. The next steps of theprogramme will concentrate on image quality evaluation, diagnostic information obtained from the different cineseries and fluoroscopy runs and analysis of the complexity for the different procedures to be correlated withpatient doses. The goal will be to establish criteria for the best management of patient doses in paediatricfluoroscopy guided procedures.