Paediatric interventional cardiology in Costa Rica: diagnostic reference levels and estimation of population dose

Ubeda, Carlos; Vañó, Eliseo; Salazar, Luisa; Retana,; Santos, Francisco Helmer Almeida; Gutiérrez, R; Manterola, Carlos

doi:10.1088/1361-6498/aa9c09

Cited by 12 publications

(7 citation statements)

References 19 publications

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“…The present nationwide survey found that the radiation dose used in pediatric diagnostic and therapeutic cardiac catheterization was much higher than reported in previous literature [7][8][9][10]. As compared with previous reports, radiation dose was remarkably high: from 2 to 4 times greater in those aged 1 to 5 years and 1.2 to 4.5 times greater in those aged 6 to 15 years (Fig.…”

Section: Discussioncontrasting

confidence: 46%

“…Data were extracted from the patient dose reports produced by the dose reporting system at the end of each procedure. Data for all procedures were divided into two groups (diagnostic and therapeutic) and four age groups that ranged from less than one year, 1-5 years, 6-10 years, and 11-15 years, as was done in previous papers [7][8][9]. From these data, we extracted the minimum, 25th percentile, median, 75th percentile, and maximum value using the boxplot method.…”

Section: Survey Items and Data Analysismentioning

confidence: 99%

“…One possible solution for optimal determination of diagnostic and therapeutic radiation doses, establishment of a local diagnostic reference level (DRL), is currently under consideration in several countries [7][8][9][10]. A certain level of control is necessary for radiation exposure of patients, therefore, the International Commission on Radiological Protection (ICRP) has recommended the use of DRLs [11].…”

Section: Introductionmentioning

confidence: 99%

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Pediatric Diagnostic Reference Levels for Diagnostic and Therapeutic Cardiac Catheterization in Japan

Ishibashi

Takei²,

Kato³

et al. 2021

Preprint

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To propose Japanese national DRLs for air-kerma at the reference point (Ka,r), air-kerma area product (PKA), fluoroscopy time (FT), and number of cine images (CI) for four age groups. We posted a nationwide questionnaire to 132 facilities. Questions focused on identifying the procedure, age, weight, height, Ka,r, PKA, FT, and CI during diagnostic and therapeutic pediatric cardiac catheterization. For diagnostic cardiac angiography, the 75th percentile values were as follows; Ka,r: 103, 127, 194, and 351 mGy; PKA: 7.0, 12.3, 14.3, and 47.2 Gy.cm2; FT: 36.8, 30.7, 33.4, and 35.7 min; and CI: 2018, 2313, 2408, and 2016 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. For therapeutic cardiac angiography, the 75th percentile values were as follows: Ka,r: 146, 209, 130, and 501 mGy; PKA: 7.54, 16.0, 8.35, and 46.0 Gy.cm2; FT: 56.5, 52.0, 49.4, and 52.0 min; and CI: 4075, 4514, 3576, and 5984 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. Our survey of diagnostic and therapeutic cardiac catheterization in Japanese pediatric patients showed that all age-based Japanese 75th percentiles for the Ka,r, PKA, FT, and CI were higher than in other surveys. Based on the result of our study, it is necessary to establish DRLs for pediatric cardiac catheterization examinations in Japan, in order to optimize the safety of pediatric protocols for diagnostic and therapeutic cardiac catheterization.

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Section: Discussioncontrasting

confidence: 46%

Section: Survey Items and Data Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pediatric Diagnostic Reference Levels for Diagnostic and Therapeutic Cardiac Catheterization in Japan

Ishibashi

Takei²,

Kato³

et al. 2021

Preprint

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“…For simplicity, others classified results by diagnostic or therapeutic procedure, or all procedures combined (Harbron 2015). Some authors presented the DRLs stratified by age band (Ghelani 2014, Ubeda 2015, Harbron et al 2016, Kottou 2018, Ubeda et al 2018 and others by weight bands (Barnaoui 2014, Kobayashi 2014, Ubeda et al 2015, Buytaert 2019, De Monte 2020, Japan Network for Research and Information on Medical Exposure 2020, Rizk 2020). Many works agreed that there is an acceptable correlation between P KA and patient weight; therefore, it could be useful to present DRLs in terms of P KA /body mass (Kobayashi et al 2014, Borik 2015, Harbron et al 2015, Ubeda et al 2015, Buytaert et al 2019, De Monte et al 2020.…”

Section: Paediatric Proceduresmentioning

confidence: 99%

Current status of diagnostic reference levels in interventional cardiology

2022

Self Cite

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Interventional cardiology provides undisputable benefits for patients but uses a substantial amount of ionising radiation. The diagnostic reference level (DRL) is the tool recommended by the International Commission on Radiological Protection to optimise imaging procedures. In this work, a review of studies dealing with radiation dose or recommending DRL values for interventional cardiology since 2010 is presented, providing quantitative and qualitative results. There are many published papers on coronary angiography and percutaneous coronary intervention. The DRL values compiled for different continental regions are different: the DRL for coronary angiography is about 35 Gy·cm2 for Europe and 83 Gy·cm2 for North America. These differences emphasise the need to establish national DRLs considering different social and/or economic factors and the harmonisation of the survey methodology. Surveys with a large amount of data collected with the help of dose management systems, provide more reliable information with less chance of statistical bias than those with a small amount of data. The complexity of procedures and improvements in technology are important factors that affect the radiation dose delivered to patients. There is a need for additional data on structural and electrophysiological procedures. The analysis of paediatric procedures is especially difficult because some studies present results split into age bands and others in weight bands. Diagnostic procedures are better described, but there is a great variety of therapeutic procedures with different DRL values (up to a factor of nine) and these require a dedicated review.

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“…The meth od ol ogy to col lect pa tient dose data and cal cu late lo cal DRL was the same as used in pre vi ous pa pers, but adapted to adult pro ce dures [11,12] and aligned with the lat est ICRP rec om men da tions [5]. The sam ple of col lected clin i cal pro ce dures was di vided into di ag nos tic and ther a peu tic pro ce dures.…”

Section: Ma Te Ri Als and Meth Odsmentioning

confidence: 99%

First local diagnostic reference levels for fluoroscopically guided cardiac procedures in adult patients in Chile

Ubeda

Martínez-García²,

Ramos³

et al. 2022

NUCL TECH RAD PROT

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The goal of this study was to generate the first values of local diagnostic reference levels for a range of fluoroscopically guided cardiac diagnostic and therapeutic procedures in adult patients in Chile and to compare radiation dose levels with others presented in the literature. The dosimetric data collection period was conducted over the whole of 2020. The local diagnostic reference levels were calculated as the 75th percentile of patient dose data distributions for kerma area-product values. The sample of collected clinical procedures (480) was divided into diagnostic and therapeutic procedures. The kerma area-product differences found between diagnostic and therapeutic procedures were statistically significant. The local diagnostic reference levels were 81.6 Gy cm2 and 166.9 Gycm2 for fluoroscopically guided cardiac diagnostic and therapeutic procedures, respectively. A comparison of our results with results found in the literature for the last 10 years, showed that there are no published papers for hospitals in Latin America and the Caribbean. It becomes urgent to be able to carry out more research of this type, given that the health reality between countries on different continents is very different. While in some the establishment of diagnostic reference levels is a legal obligation, in others it is a matter of good or bad will.

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Paediatric interventional cardiology in Costa Rica: diagnostic reference levels and estimation of population dose

Cited by 12 publications

References 19 publications

Pediatric Diagnostic Reference Levels for Diagnostic and Therapeutic Cardiac Catheterization in Japan

Pediatric Diagnostic Reference Levels for Diagnostic and Therapeutic Cardiac Catheterization in Japan

Current status of diagnostic reference levels in interventional cardiology

First local diagnostic reference levels for fluoroscopically guided cardiac procedures in adult patients in Chile

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