Cody J Schwartz1, Ari J Isaacson2, Lynn Ansley Fordham2, Marija Ivanovic2, J Bradford Taylor3, Robert G Dixon2. 1. Department of Radiology, UNC Health Care, University of North Carolina at Chapel Hill, 101 Manning Drive, CB 7510, Chapel Hill, NC, 27599, USA. Cody.Schwartz@unchealth.unc.edu. 2. Department of Radiology, UNC Health Care, University of North Carolina at Chapel Hill, 101 Manning Drive, CB 7510, Chapel Hill, NC, 27599, USA. 3. Environment, Health and Safety, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Abstract
BACKGROUND: To date, there are limited radiation dose data on CT-guided procedures in pediatric patients. OBJECTIVE: Our goal was to quantify the radiation dose associated with pediatric CT-guided drain placement and follow-up drain evaluations in order to estimate effective dose. MATERIALS AND METHODS: We searched the electronic medical record and picture archiving and communication system (PACS) to identify all pediatric (<18 years old) CT-guided drain placements performed between January 2008 and December 2013 at our institution. We compiled patient data and radiation dose information from CT-guided drain placements as well as pre-procedural diagnostic CTs and post-procedural follow-up fluoroscopic abscess catheter injections (sinograms). Then we converted dose-length product, fluoroscopy time and number of acquisitions to effective doses using Monte Carlo simulations and age-appropriate conversion factors based on annual quality-control testing. RESULTS: Fifty-two drainages were identified with mean patient age of 11.0 years (5 weeks to 17 years). Most children had diagnoses of appendicitis (n=23) or inflammatory bowel disease (n=11). Forty-seven patients had diagnostic CTs, with a mean effective dose of 7.3 mSv (range 1.1-25.5 mSv). Drains remained in place for an average of 16.9 days (range 0-75 days), with an average of 0.9 (0-5) sinograms per patient in follow-up. The mean effective dose for all drainages and follow-up exams was 5.3 mSv (0.7-17.1) and 62% (32/52) of the children had effective doses less than 5 mSv. CONCLUSION: The majority of pediatric patients who have undergone CT-guided drain placements at our institution have received total radiation doses on par with diagnostic ranges. This information could be useful when describing the dose of radiation to parents and providers when CT-guided drain placement is necessary.
BACKGROUND: To date, there are limited radiation dose data on CT-guided procedures in pediatric patients. OBJECTIVE: Our goal was to quantify the radiation dose associated with pediatric CT-guided drain placement and follow-up drain evaluations in order to estimate effective dose. MATERIALS AND METHODS: We searched the electronic medical record and picture archiving and communication system (PACS) to identify all pediatric (<18 years old) CT-guided drain placements performed between January 2008 and December 2013 at our institution. We compiled patient data and radiation dose information from CT-guided drain placements as well as pre-procedural diagnostic CTs and post-procedural follow-up fluoroscopic abscess catheter injections (sinograms). Then we converted dose-length product, fluoroscopy time and number of acquisitions to effective doses using Monte Carlo simulations and age-appropriate conversion factors based on annual quality-control testing. RESULTS: Fifty-two drainages were identified with mean patient age of 11.0 years (5 weeks to 17 years). Most children had diagnoses of appendicitis (n=23) or inflammatory bowel disease (n=11). Forty-seven patients had diagnostic CTs, with a mean effective dose of 7.3 mSv (range 1.1-25.5 mSv). Drains remained in place for an average of 16.9 days (range 0-75 days), with an average of 0.9 (0-5) sinograms per patient in follow-up. The mean effective dose for all drainages and follow-up exams was 5.3 mSv (0.7-17.1) and 62% (32/52) of the children had effective doses less than 5 mSv. CONCLUSION: The majority of pediatric patients who have undergone CT-guided drain placements at our institution have received total radiation doses on par with diagnostic ranges. This information could be useful when describing the dose of radiation to parents and providers when CT-guided drain placement is necessary.
Authors: Bilal A Ahmed; Bairbre L Connolly; Puneet Shroff; Amy Lee Chong; Christopher Gordon; Ronald Grant; Mark L Greenberg; Karen E Thomas Journal: Pediatrics Date: 2010-09-27 Impact factor: 7.124
Authors: Donald L Miller; Stephen Balter; Patricia E Cole; Hollington T Lu; Beth A Schueler; Michael Geisinger; Alejandro Berenstein; Robin Albert; Jeffrey D Georgia; Patrick T Noonan; John F Cardella; James St George; Eric J Russell; Tim W Malisch; Robert L Vogelzang; George L Miller; Jon Anderson Journal: J Vasc Interv Radiol Date: 2003-06 Impact factor: 3.464