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Patient radiation doses and reference levels in pediatric interventional radiology

  • Paediatric
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Abstract

Objectives

To describe, in a multicentric paediatric population, reference levels (RLs) for three interventional radiological procedures.

Methods

From January 2012 to March 2015, children scheduled for an interventional radiological procedure in two French tertiary centres were retrospectively included and divided into four groups according to age: children younger than 2 years (A1), aged 2–7 years (A5), 8–12 years (A10) and 13–18 years (A15). Three procedures were identified: cerebral digital subtraction angiography (DSA), brain arteriovenous malformation (bAVM) embolization, and head and neck superficial vascular malformation (SVM) percutaneous sclerotherapy. Demographic and dosimetric data, including dose area product (DAP), were collected.

Results

550 procedures were included. For DSA (162 procedures), the proposed RL values in DAP were 4, 18, 12 and 32 Gy∙cm2 in groups A1, A5, A10 and A15, respectively. For bAVM embolization (258 procedures), values were 33, 70, 105 and 88 Gy∙cm2 in groups A1, A5, A10 and A15, respectively. For SVM sclerotherapy (130 procedures), values were 350, 790, 490 and 248 mGy∙cm2 in groups A1, A5, A10 and A15, respectively.

Conclusion

Consecutive data were available to permit a proposal of reference levels for three major paediatric interventional radiology procedures.

Key Points

We determined reference levels (RLs) for bAVM embolization, DSA and SVM sclerotherapy.

The proposed RLs will permit benchmarking practice with an external standard.

The proposed RLs by age may help to develop paediatric dose guidelines.

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Abbreviations

bAVM:

Brain arteriovenous malformation

BMI:

Body mass index

CI:

Confidence intervals

DAP:

Dose area product

DRL:

Diagnostic reference level

RL:

Reference level

DSA:

Cerebral digital subtraction angiography

HC:

Head circumference

ICRP:

International Commission on Radiological Protection

IQR:

Interquartile range

K:

Air kerma at the reference point

n:

Number of studies

N:

Number of acquisition frames

SD:

Standard deviation

SVM:

Superficial vascular malformation

T:

Fluoroscopic time

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Acknowledgements

The scientific guarantor of this publication is Olivier Naggara. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Written informed consent was waived by the Institutional Review Board. Institutional Review Board approval was obtained. Methodology: retrospective, observational, multicentre study.

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Correspondence to Olivier Naggara.

Additional information

Olivier Naggara and Guillaume Saliou contributed equally to this paper

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Habib Geryes, B., Bak, A., Lachaux, J. et al. Patient radiation doses and reference levels in pediatric interventional radiology. Eur Radiol 27, 3983–3990 (2017). https://doi.org/10.1007/s00330-017-4769-0

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  • DOI: https://doi.org/10.1007/s00330-017-4769-0

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