A systematic review of conversion factors between kerma-area product and effective/organ dose for cardiac interventional fluoroscopy procedures performed in adult and paediatric patients

Abstract

The aim of this systematic review is to undertake a critical appraisal of the evidence in the published literature concerning the conversion factors between kerma-area product (PKA) and effective/organ dose (DCED_PKA, DCHT_PKA) for cardiac interventional fluoroscopy procedures performed in adults and paediatric patients and to propose reference conversion factors to help standardize dose calculations. A search strategy utilizing MeSH headings in three databases identified 59 (adult) and 37 (paediatric) papers deemed eligible for the review. Exclusion criteria were adopted to select data only from publications which established DCED_PKA in patients using the ICRP103 tissue weighting factors. A time restriction from January 2007 was introduced in the search to capture the evolving trends of utilization of fluoroscopy-guided intervention technologies only in recent years. The suggested DCED_PKA and DCHT_PKA were synthesized by calculating the weighted averages of the values reported by the authors with weights corresponding to the study sample size. Eighteen studies for both adult (9) and paediatric (9) patients matching the search terms fulfilled the inclusion criteria. The suggested value for DCED_PKA in adult patients amounts to 0.24 mSvGy-1cm-2. The suggested values for DCHT_PKA ranged from a minimum of 0.15 mSvGy-1cm-2 for the female breast to a maximum of 0.97 mSvGy-1cm-2 for the lungs. The suggested values for DCED_PKA in paediatric patients ranged from 3.45 mSvGy-1cm-2 for the new-born to 0.49 mSvGy-1cm-2 in the 15-years age class. The suggested values for DCHT_PKA ranged from a minimum of 0.33 mSvGy-1cm-2 for bone marrow in the 15-years age class to a maximum of 11.49 mSvGy-1cm-2 for the heart in the new-born. To conclude, values of DCED_PKA/DCHT_PKA were provided for calculating effective/organ doses in cardiac interventional procedures. They can be useful for standardizing dose calculations, hence for comparison of the radiation detriment from different imaging procedures and in the framework of epidemiologic studies.

Optimal conversion coefficient from easily measurable dose to effective dose with consideration to radiation quality for posterior–anterior chest radiography

“…Among these methods, that using an effective dose conversion coefficient does not require a human body model phantom or simulation software necessary to calculate the effective dose, and can be easily calculated from the dose index listed in the diagnostic reference levels. So far, studies of conversion coefficients have been conducted in the fields of general radiography [9][10][11], CT [12,13], and interventional radiology (IVR) [14,15]. Although conversion coefficients have been studied for a long time in general radiography, fewer studies have used the tissue weighting factors proposed in ICRP103 for general radiography, compared with those for other modalities.…”