BACKGROUND: Interventional procedures frequently employ fluoroscopy or digital subtraction angiography (DSA). Few studies have documented radiation doses received by children during these procedures. OBJECTIVE: To measure skin entrance dose received during common pediatric interventional procedures. MATERIALS AND METHODS: MOSFET dosimeters were placed to record skin doses in 143 children undergoing any of five procedures: 30 PICC insertions, 34 CVL/port insertions, 30 G/GJ tube insertions, 25 sclerotherapy/vascular anomaly procedures, 24 cerebral angiography procedures. The highest recorded dose (HRD) from the five MOSFET probes was assumed to be the peak skin dose per child. HRD values were averaged for children within each group and correlated with patient weight, fluoroscopy time and number of DSA frames. RESULTS: Average HRD was 1.8 mGy for PICC insertions, 1.4 mGy for CVL/port insertions, 3.9 mGy for G/GJ tube insertions, 39.1 mGy for sclerotherapy/vascular anomaly procedures, and 149.9 and 101.6 mGy for frontal and lateral portions of cerebral angiography procedures. These entrance doses corresponded to effective dose estimates in the range 0.4-3 mSv. There were only modest correlations between peak skin dose and fluoroscopy time, patient weight and DSA frames (r (2)<0.4, P < 0.01). CONCLUSION: Pediatric interventional procedures are associated with a wide range of doses; those at the higher end require careful monitoring.
BACKGROUND: Interventional procedures frequently employ fluoroscopy or digital subtraction angiography (DSA). Few studies have documented radiation doses received by children during these procedures. OBJECTIVE: To measure skin entrance dose received during common pediatric interventional procedures. MATERIALS AND METHODS: MOSFET dosimeters were placed to record skin doses in 143 children undergoing any of five procedures: 30 PICC insertions, 34 CVL/port insertions, 30 G/GJ tube insertions, 25 sclerotherapy/vascular anomaly procedures, 24 cerebral angiography procedures. The highest recorded dose (HRD) from the five MOSFET probes was assumed to be the peak skin dose per child. HRD values were averaged for children within each group and correlated with patient weight, fluoroscopy time and number of DSA frames. RESULTS: Average HRD was 1.8 mGy for PICC insertions, 1.4 mGy for CVL/port insertions, 3.9 mGy for G/GJ tube insertions, 39.1 mGy for sclerotherapy/vascular anomaly procedures, and 149.9 and 101.6 mGy for frontal and lateral portions of cerebral angiography procedures. These entrance doses corresponded to effective dose estimates in the range 0.4-3 mSv. There were only modest correlations between peak skin dose and fluoroscopy time, patient weight and DSA frames (r (2)<0.4, P < 0.01). CONCLUSION: Pediatric interventional procedures are associated with a wide range of doses; those at the higher end require careful monitoring.
Authors: Terry T Yoshizumi; Philip C Goodman; Donald P Frush; Giao Nguyen; Greta Toncheva; Maksudur Sarder; Lottie Barnes Journal: AJR Am J Roentgenol Date: 2007-05 Impact factor: 3.959
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