Estimating patient dose and radiology practice from interventional cardiology procedures in the paediatric cardiology department in Bulgaria

Abstract

Introduction The radiation dose from interventional cardiology procedures is essential when treating children because of their greater radiosensitivity compared with adults. Purpose The purpose of the present study was to estimate patient dose and radiology practice from interventional procedures in the only paediatric cardiology department in Bulgaria. The dedicated angiographic equipment is used for both adult and paediatric procedures. Materials and methods Data for 54 paediatric patients was collected over a five month period. Two most common procedures were included: coronary angiography (CA) (42 patients) and percutaneous coronary intervention (CA + PCI) (12 patients). For each patient the following information was collected: sex, age, weight, and height, frame rate, total fluoroscopy time (FT), number of acquired series/images, dose area product (DAP) and kerma at IRP. Body mass index for each patient was calculated. Results Data were analyzed by grouping the patients in age and weight groups, and comparison will be presented. For children who underwent CA procedures a weak correlation was found between the DAP and weight values ( r 2 = 0.627). Large variation of the dose parameters were found within the groups. For better statistics age groups are presented. The average DAP values for CA procedures were 137.6 (range 54.9–285.04) cGy.cm 2 for age group (0–12 months), 269.8 (48.4–830.2) cGy.cm 2 for (1–4 years), 275.8 (54.5–751.0) cGy.cm 2 for (5–9 years) and 878.7 (313.6–1766.4) cGy.cm 2 for (10–15 years). Data for CA + PCI procedures was analyzed for groups (1–4 years) and (10–15 years). The average DAP values were 457.8 (177.2 –1037.2) cGy.cm 2 and 948.2 (703.9–1318.4) cGy.cm 2 respectively. The average FT for CA was: (0–12 m)–12.0 (6.7–26.6) min; (1–4 y)–15.7 (1.7–40.6) min; (5–9 y)–10.1 (0.9–30.3) min; (10–15 y)–11.6 (2.9–31.0) min. The average kerma at IRP values for CA were: 16.0 (7.6–41.52) mGy for (0–12 m); 18.5 (4.2–54.2) mGy for (1–4 y); 17.2 (2.6–45.7) mGy for (5–9 y) and 51.0 (15.1–126.3) mGy for (10–15 y). The average FT for CA + PCI was: 25.8 (4.8–65.7) min for (1–4 y) and 17.5 (7.6–27.1) min for (10–15 y). The average kerma at IRP values for CA + PCI were: 37.1 (15.1–77.7) mGy for (1–4 y) and 50.2 (39.2–77.1) mGy for (10–15 y). Conclusion The dose values are lower than the typical doses for adult patients but higher than reported from other studies which shows the potential for optimization of the radiology practice.