Typical values for pediatric interventional cardiology catheterizations: A standardized approach towards Diagnostic Reference Level establishment |
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| Institution: | 1. Medical Physics Department, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy;2. Pediatric Cardiology Unit, Department of Woman and Child''s Health, University of Padua, Padua, Italy;3. Medical Physics Department, ASST Valtellina e Alto Lario, Sondrio, Italy;1. Department of Radiotherapy, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany;2. Department of Radiology, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany;3. Department of Physics, University of Osijek, Trg Ljudevita Gaja 6, 31000 Osijek, Croatia;4. Clinic and Polyclinic for Diagnostic and Interventional Radiology, University Hospital Leipzig, Liebigstraße 20, 04103 Leipzig, Germany;1. Department of Medical Physics & Nuclear Medicine, Karolinska University Hospital, S-171 76 Stockholm, Sweden;2. Department of Radiation Physics, Faculty of Health Sciences, Linköping University, S-581 85 Linköping, Sweden;1. Department of Clinical Radiology, Kagawa University Hospital, Kagawa, Japan;2. Graduate School of Medicine, Kagawa University, Kagawa, Japan;3. Department of Radiation Oncology, Kagawa University Hospital, Kagawa, Japan;1. Medical Technology Department, Health Sciences Faculty, Universidad de Tarapacá, Arica, Chile;2. Radiology Department, Faculty of Medicine, Complutense University and IdIS, San Carlos Hospital, 28040 Madrid, Spain;3. Hemodynamic Department, Cardiovascular Service, Luis Calvo Mackenna Hospital, Santiago, Chile;1. Laboratory of High Energy Physics, Modelisation and Simulation, Faculty of Sciences, Rabat, Morocco;2. Unità Operativa di Fisica Medica “Fondazione Ca ''Granda - Ospedale Maggiore Policlinico”, Milano, Italy |
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| Abstract: | PurposeTo define weight-stratified Diagnostic Reference Levels (DRL) typical values for pediatric interventional cardiology (IC) procedures adopting standardized methodologies proposed by ICRP135 and RP185.MethodsProcedures performed at the pediatric catheterization room of the University-Hospital of Padua were analysed. Patients were stratified into body weight (BW) classes and DRL quantities were analysed for the most performed procedures. Typical values are defined as median PKA and Ka,r. For database consistency, sampling and exclusion methods were precisely defined. The DRL-curve methodology by means of quantile regression median curves was investigated to assess the relationship between PKA and weight. A like-to-like comparison with literature was made.Results385 procedures were analysed. A large PKA variability was observed in each weight group. PKA differences across BW groups were not always statistically significant. When stratifying by procedure, PKA variability decreased while correlations of PKA and PKA/FT with weight increased. The established typical values are generally lower than DRLs published data, whatever stratification method adopted. The highest PKA median values were observed for Angioplasty (4.9 and 11.6 Gycm2 for 5-<15 kg and 15-<30 kg, respectively). The DRL-curve approach shows promising results for Valvuloplasty and Angioplasty.ConclusionsTypical values for pediatric IC DRL quantities were determined according to ICRP135 and RP185 methodologies. Stratification by BW classification does not reduce the variability of the PKA values, unlike what happens when stratifying by procedure type. Results seem to corroborate that variability and exposure are more affected by procedure type and complexity than by patient weight. DRL-curve is a feasible approach. |
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| Keywords: | Diagnostic Reference Level Typical value Pediatric Interventional cardiology |
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