Marcel Opitz1, Denise Bos2, Cornelius Deuschl2, Alexander Radbruch2, Sebastian Zensen2, Selma Sirin2, Michael Forsting2, Nikolaos Bechrakis3, Eva Biewald3, Norbert Bornfeld3, Petra Ketteler4, Beate Timmermann5, Martin Stuschke6, Maja Guberina6, Axel Wetter2, Sophia Göricke2, Nika Guberina2,6. 1. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. marcel.opitz@uk-essen.de. 2. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. 3. Department of Ophthalmology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. 4. Department of Pediatric Hematology and Oncology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. 5. Department of Particle Therapy, University Hospital Essen, West German Cancer Center, German Cancer Consortium (DKTK), Hufelandstrasse 55, 45147, Essen, Germany. 6. Department of Radiotherapy, University Hospital Essen, West German Cancer Center, Hufelandstrasse 55, 45147, Essen, Germany.
Abstract
PURPOSE: This study aims to determine local diagnostic reference levels (LDRLs) of intra-arterial chemotherapy (IAC) procedures of pediatric patients with retinoblastoma (RB) to provide data for establishing diagnostic reference levels (DRLs) in pediatric interventional radiology (IR). METHODS: In a retrospective study design, LDRLs and achievable dose (AD) were assessed for children undergoing superselective IAC for RB treatment. All procedures were performed at the flat-panel angiography systems (I) ArtisQ biplane (Siemens Healthineers) and (II) Allura Xper (Philips Healthcare). Patients were differentiated according to age (A1: 1-3 months; A2: 4-12 months; A3: 13-72 months; A4: 73 months-10 years; A5: > 10 years), sex, conducted or not-conducted chemotherapy. RESULTS: 248 neurointerventional procedures of 130 pediatric patients (median age 14.5 months, range 5-127 months) with RB (68 unilateral, 62 bilateral) could be included between January 2010 and March 2020. The following diagnostic reference values, AD, and mean values could be determined: (A2) DRL 3.9 Gy cm2, AD 2.9 Gy cm2, mean 3.5 Gy cm2; (A3) DRL 7.0 Gy cm2, AD 4.3 Gy cm2, mean 6.0 Gy cm2; (A4) DRL 14.5 Gy cm2, AD 10.7 Gy cm2, mean 10.8 Gy cm2; (A5) AD 8.8 Gy cm2, mean 8.8 Gy cm2. Kruskal-Wallis-test confirmed a significant dose difference between the examined age groups (A2-A5) (p < 0.001). There was no statistical difference considering sex (p = 0.076) and conducted or not-conducted chemotherapy (p = 0.627). A successful procedure was achieved in 207/248 cases. CONCLUSION: We report on radiation exposure during superselective IAC of a pediatric cohort at the German Retinoblastoma Referral Centre. Although an IAC formally represents a therapeutic procedure, our results confirm that radiation exposure lies within the exposure of a diagnostic interventional procedure. DRLs for superselective IAC are substantially lower compared with DRLs of more complex endovascular interventions.
PURPOSE: This study aims to determine local diagnostic reference levels (LDRLs) of intra-arterial chemotherapy (IAC) procedures of pediatric patients with retinoblastoma (RB) to provide data for establishing diagnostic reference levels (DRLs) in pediatric interventional radiology (IR). METHODS: In a retrospective study design, LDRLs and achievable dose (AD) were assessed for children undergoing superselective IAC for RB treatment. All procedures were performed at the flat-panel angiography systems (I) ArtisQ biplane (Siemens Healthineers) and (II) Allura Xper (Philips Healthcare). Patients were differentiated according to age (A1: 1-3 months; A2: 4-12 months; A3: 13-72 months; A4: 73 months-10 years; A5: > 10 years), sex, conducted or not-conducted chemotherapy. RESULTS: 248 neurointerventional procedures of 130 pediatric patients (median age 14.5 months, range 5-127 months) with RB (68 unilateral, 62 bilateral) could be included between January 2010 and March 2020. The following diagnostic reference values, AD, and mean values could be determined: (A2) DRL 3.9 Gy cm2, AD 2.9 Gy cm2, mean 3.5 Gy cm2; (A3) DRL 7.0 Gy cm2, AD 4.3 Gy cm2, mean 6.0 Gy cm2; (A4) DRL 14.5 Gy cm2, AD 10.7 Gy cm2, mean 10.8 Gy cm2; (A5) AD 8.8 Gy cm2, mean 8.8 Gy cm2. Kruskal-Wallis-test confirmed a significant dose difference between the examined age groups (A2-A5) (p < 0.001). There was no statistical difference considering sex (p = 0.076) and conducted or not-conducted chemotherapy (p = 0.627). A successful procedure was achieved in 207/248 cases. CONCLUSION: We report on radiation exposure during superselective IAC of a pediatric cohort at the German Retinoblastoma Referral Centre. Although an IAC formally represents a therapeutic procedure, our results confirm that radiation exposure lies within the exposure of a diagnostic interventional procedure. DRLs for superselective IAC are substantially lower compared with DRLs of more complex endovascular interventions.
Authors: Célia B G Antoneli; Karina de Cássia B Ribeiro; Luis Henrique Sakamoto; Martha M Chojniak; Paulo Eduardo R S Novaes; Victor E A Arias Journal: Pediatr Blood Cancer Date: 2007-03 Impact factor: 3.167
Authors: Daniel L Cooke; Charles E Stout; Warren T Kim; Steven W Hetts; Randall T Higashida; Van V Halbach; Christopher F Dowd; Robert G Gould Journal: J Neurointerv Surg Date: 2014-01-02 Impact factor: 5.836
Authors: S Barnaoui; J L Rehel; H Baysson; Y Boudjemline; B Girodon; M O Bernier; D Bonnet; B Aubert Journal: Pediatr Cardiol Date: 2014-03-21 Impact factor: 1.655
Authors: Carol L Shields; Fairooz P Manjandavida; Sara E Lally; Giulia Pieretti; Sruthi A Arepalli; Emi H Caywood; Pascal Jabbour; Jerry A Shields Journal: Ophthalmology Date: 2014-03-21 Impact factor: 12.079
Authors: Sheila Thampi; Steven W Hetts; Daniel L Cooke; Paul J Stewart; Elizabeth Robbins; Anuradha Banerjee; Steven G Dubois; Devron Char; Van Halbach; Katherine Matthay Journal: Clin Ophthalmol Date: 2013-05-27