Local diagnostic reference levels for paediatric non-cardiac interventional radiology procedures

Abstract

PurposeTo establish local diagnostic reference levels (DRLs) for non-cardiac interventional procedures in paediatrics. MethodsThe 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. ResultsLocal DRLs are proposed for three types of procedures: hepatic/biliary interventions (5–15 kg, 1304 cGy·cm2; 15–30 kg, 2121 cGy·cm2), sclerotherapy procedures (15–30 kg, 704 cGy·cm2; 30–50 kg, 4049 cGy·cm2; 50–80 kg, 3734 cGy·cm2) and central venous catheter (CVC) procedures (5–15 kg, 84 cGy·cm2). 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). ConclusionsThe 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.