Abstract
Objectives To quantify radiation exposure during pediatric cardiac catheterizations performed by multiple operators on a new imaging platform, the Artis Q.zen (Siemens Healthcare, Forchheim, Germany), and to compare these data to contemporary benchmark values. Background The Artis Q.zen has been shown to achieve significant radiation reduction during select types of pediatric cardiac catheterizations in small single-center studies. No large multicenter study exists quantifying patient dose exposure for a broad spectrum of procedures. Methods Retrospective collection of Air Kerma (AK) and dose area product (DAP) for all pediatric cardiac catheterizations performed on this new imaging platform at four institutions over a two-year time period. Results A total of 1,127 pediatric cardiac catheterizations were analyzed. Compared to dose data from earlier generation Artis Zee imaging systems, this study demonstrates 70–80% dose reduction (AK and DAP) for similar patient and procedure types. Compared to contemporary benchmark data for common interventional procedures, this study demonstrates an average percent reduction in AK and DAP from the lowest dose saving per intervention of 39% for AK and 27% for DAP for transcatheter pulmonary valve implantation up to 77% reduction in AK and 70% reduction in DAP for atrial septal defect closure. Conclusion Use of next-generation imaging platforms for pediatric cardiac catheterizations can substantially decrease patient radiation exposure. This multicenter study defines new low-dose radiation measures achievable on a novel imaging system.
Highlights
Guided diagnostic and interventional catheterizations play a vital role in the management of patients with congenital heart disease (CHD)
Due to the increasing procedural complexity and frequent need for repeated studies, these cardiac catheterizations may account for more cumulative radiation exposure than all other imaging modalities combined throughout a CHD patient’s lifetime. is radiation exposure often begins early in childhood, a time associated with greatest long-term risk for malignancies [1, 2]
With increased recognition of the radiation risks, there have been concerted e orts to decrease both patient and operator exposure through implementation of As Low As Reasonably Achievable (ALARA) principles and standards advocated by national radiation reduction quality improvement e orts [3, 4]. rough use of imaging guidelines set forth, several studies have documented signi cant reduction in radiation exposure during pediatric catheterizations [5,6,7], and the current trend is away from detailed high-quality imaging toward adequate image quality to perform procedures safely at the lowest acceptable dose
Summary
Guided diagnostic and interventional catheterizations play a vital role in the management of patients with congenital heart disease (CHD). With increased recognition of the radiation risks, there have been concerted e orts to decrease both patient and operator exposure through implementation of As Low As Reasonably Achievable (ALARA) principles and standards advocated by national radiation reduction quality improvement e orts [3, 4]. Novel imaging systems are available with complementary metal-oxide-semiconductor (CMOS) flatpanel x-ray detectors (FD) that increase the acquired image bit depth and employ crystalline silicon instead of amorphous silicon as a photodetector. Both improvements offer reduction in radiation dose to obtain similar image quality due to better digitalization and lower detector noise. X-ray tubes have been introduced that changed from classic coil filaments for photon generation to flat emitters, which maximize contrast, spatial, and temporal resolution through generation of more coherent focal spots, leading to further radiation dose reduction
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
