Local diagnostic reference levels for paediatric non-cardiac interventional radiology procedures. (April 2020)

• Record Type: Journal Article
• Authors: Morcillo, Ana Belén; Alejo, Luis; Huerga, Carlos; Bayón, José; Obesso, Alba; Corredoira, Eva; Novo, Joan Ricardo; Hernández, Teresa; Ponce, María Dolores; Fernández, Lucía; Rodríguez, Ricardo; Garzón, Gonzalo; Vañó, Eliseo; Guibelalde, Eduardo
• Is Part Of: Physica medica. Volume 72(2020)
• Page Start: 1
• Page End: 6
• Publication Date: 2020-04
• Subjects: Paediatrics -- Interventional radiology -- Diagnostic reference levels -- Radiation protection; Medical physics -- Periodicals; Biophysics -- Periodicals; Biophysics -- Periodicals; Imagerie médicale -- Périodiques; Radiothérapie -- Périodiques; Rayons X -- Sécurité -- Mesures -- Périodiques; Physique -- Périodiques; Médecine -- Périodiques; 610.153
• DOI: 10.1016/j.ejmp.2020.03.001
• Languages: English
• ISSNs: 1120-1797

Abstract

Highlights: First diagnostic reference levels in paediatric interventional radiology in Europe. Local diagnostic reference levels are obtained for hepatic/biliary interventions. Local diagnostic reference levels are establish for sclerotherapy procedures. Local diagnostic reference levels are obtained for central venous catheter insertions. The kerma-area product is highly dependent on complexity rather than on weight. Abstract: Purpose: To establish local diagnostic reference levels (DRLs) for non-cardiac interventional procedures in paediatrics. Methods: The type of procedure, the patient's weight and age and dose-related data from 279 interventions was recorded in a database completed by interventional radiologists, radiographers and technicians of the Medical Physics department. These procedures were classified into 14 categories and 6 weight ranges. Local DRLs were proposed for those ranges in which a sample of at least 15 patients could be gathered and were calculated as the third quartile (Q3) of the air kerma-area product (PKA ) values. The Q3 of the fluoroscopy time (FT) and number of digital subtraction angiography (DSA) images were also obtained. Finally, the correlation between PKA and weight was analysed. Results: Local DRLs are proposed for three types of procedures: hepatic/biliary interventions (5–15 kg, 1304 cGy·cm 2 ; 15–30 kg, 2121 cGy·cm 2 ), sclerotherapy procedures (15–30 kg, 704 cGy·cm 2 ; 30–50 kg, 4049 cGy·cm 2 ; 50–80 kg, 3734 cGy·cm 2 ) and central venous catheter (CVC) procedures (5–15 kg, 84 cGy·cm 2 ). Hepatic/biliary interventions showed a moderate correlation (r = 0.61), while sclerotherapy procedures presented a poor correlation (r = 0.34) between PKA and weight, possibly due to the PKA dependence on the complexity level. Regarding CVC procedures, a clearly higher correlation was found when the fluoroscopy PKA value was normalised to the FT (r = 0.85 vs r = 0.35). Conclusions: The results support the feasibility of establishing DRLs for the most common procedures (sclerotherapy, hepatic/biliary and CVC interventions) despite the small number of paediatric interventions.