New Optimization Strategies on Radiation Protection in Fluoroscopy-Guided Interventional Procedures in Pediatrics

Ubeda, Carlos

doi:10.3390/children10050883

Cited by 5 publications

(4 citation statements)

References 5 publications

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“…The OPRIPALC (Optimization of Protection in Paediatric Interventional Radiology in Latin America and the Caribbean) project is one of the first regional programmes promoted by the World Health Organisation (WHO), together with the PAHO (Pan American Health Organization) and the IAEA (International Atomic Energy Agency) to improve the RP in paediatric interventional practices, particularly in cardiology [4,5].…”

Section: Introductionmentioning

confidence: 99%

Improving a regional project on diagnostic reference levels for interventional procedures (OPRIPALC) with the support of a dose management system for the protection of patients and staff

Vano,

Fernández-Soto,

Sánchez-Casanueva

et al. 2024

J. Radiol. Prot.

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Interventional radiology is a clinical practice with important benefits for patients, but which involves high radiation doses. The optimisation of radiation protection for paediatric interventional cardiology is a priority for both patients and staff. The use of diagnostic reference levels (DRLs) has been proposed by the International Commission on Radiological Protection to improve radiation protection in imaging procedures. Dose management systems (DMSs) allow the automatic collection of dosimetric, geometric and technical data to assist the optimisation process, with a continuous audit of the procedures, generating alerts to implement corrective actions when necessary. Patient dose indicators may be analysed individually and for different radiation events (fluoroscopy and cine runs). Occupational doses per procedure may be analysed (if electronic dosimeters are available) and linked with patient doses for an integrated approach to radiation protection. Regional optimisation programmes require data collection and processing from several countries to set and periodically update the DRLs. Patient data is anonymised, and each participating hospital has access to their data in a central computer server. Using DMSs may be one of the best ways to support these programs in the collection and analysis of data, raising alerts about high patient and occupational doses and suggesting optimisation actions.

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Section: Introductionmentioning

confidence: 99%

Improving a regional project on diagnostic reference levels for interventional procedures (OPRIPALC) with the support of a dose management system for the protection of patients and staff

Vano,

Fernández-Soto,

Sánchez-Casanueva

et al. 2024

J. Radiol. Prot.

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“…The analysis of these patient dose metrics and the establishment of diagnostic reference levels (DRLs), classified by weight and age group, can help formulate a strategy to optimize doses and avoid unnecessarily high doses in pediatric patients [10]. Motivated by the participation in the "Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean" (OPRIPALC) initiative launched in 2018 [11,12], this study aims to propose a first set of Brazilian DRLs for pediatric interventional diagnostic and therapeutic procedures.…”

Section: Introductionmentioning

confidence: 99%

An Approach to Establishing Diagnostic Reference Levels in Interventional Pediatric Cardiology from Different Regions of Brazil

Asfora,

Freitas,

Medeiros

et al. 2024

Children

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Diagnostic reference levels (DRLs) are a pivotal strategy to be implemented since pediatric interventional cardiology procedures are increasing. This work aimed to propose an initial set of Brazilian DRLs for pediatric interventional diagnostic and therapeutic (D&T) procedures. A retrospective study was carried out in four Brazilian states, distributed across the three regions of the country. Data were collected from pediatric patients undergoing cardiac interventional procedures (CIPs), including their age and anthropometric characteristics, and at least four parameters (number of images, exposure time, air kerma–area product—PKA, and cumulative air kerma). Data from 279 patients undergoing CIPs were gathered (147 diagnostic and 132 therapeutic procedures). There were no significant differences in exposure time and the number of images between the D&T procedures. A wide range of PKA was observed when the therapeutic procedures were compared to diagnostics for all age groups. There were significant differences between the D&T procedures, whether grouping data by patient weight or age. In terms of cumulative air kerma, it was noted that no value exceeded the level to trigger a monitoring process for patients. This study shows that it is possible to adopt them as the first proposal to establish national DRLs considering pediatric patient groups.

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“…This work has been conducted in the framework of the "Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean" (OPRIPALC) program coordinated by the World Health Organization and the Pan American Health Organization in cooperation with the International Atomic Energy Agency [9,10].…”

Section: Introductionmentioning

confidence: 99%

Local Diagnostic Reference Levels for Pediatric Interventional Cardiology Procedures in Argentina

Azcurra,

Leyton,

Lucini

et al. 2023

Children

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The aim of this work was to propose a preliminary local diagnostic reference levels (DRL) for pediatric interventional cardiology (PIC) procedures in Argentina, for different ranges of age and weight. This work has been conducted in the framework of the “Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean” (OPRIPALC) program coordinated by the World Health Organization and the Pan American Health Organization in cooperation with the International Atomic Energy Agency to ensuring that radiation exposures of pediatric patients are the minimum necessary during fluoroscopy-guided interventional procedures. The local DRL values presented in this paper by weight group and age group were 7.1 Gy·cm2 (<5 kg), 10.7 Gy·cm2 (5–15 kg), 18.0 Gy·cm2 (15–30 kg), 15.9 Gy·cm2 (30–50 kg), and 28.2 Gy·cm2 (50–80 kg) and 5.3 Gy·cm2 (<1), 11.2 Gy·cm2 (1 to 5<), 19.6 Gy·cm2 (5 to 10<), and 21.4 Gy·cm2 (10 to 16<), respectively. Our dose results are among the values found in other international studies; however, there is great potential for dose optimization.

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New Optimization Strategies on Radiation Protection in Fluoroscopy-Guided Interventional Procedures in Pediatrics

Cited by 5 publications

References 5 publications

Improving a regional project on diagnostic reference levels for interventional procedures (OPRIPALC) with the support of a dose management system for the protection of patients and staff

Improving a regional project on diagnostic reference levels for interventional procedures (OPRIPALC) with the support of a dose management system for the protection of patients and staff

An Approach to Establishing Diagnostic Reference Levels in Interventional Pediatric Cardiology from Different Regions of Brazil

Local Diagnostic Reference Levels for Pediatric Interventional Cardiology Procedures in Argentina

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