Patient doses in paediatric interventional cardiology: impact of 3D rotational angiography

Corredoira, E.; Vañó, Eliseo; Ubeda, Carlos; Gutiérrez-Larraya, Federico

doi:10.1088/0952-4746/35/1/179

Cited by 24 publications

(8 citation statements)

References 15 publications

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“…Recording P KA and K a,r for the cone-beam CT portion of interventional procedures, when this information is available, may be helpful in optimisation of this portion of interventional procedures (Section 5.3.3). The same is true for three-dimensional rotational angiography (Corredoira et al., 2015).…”

Section: Interventional Proceduresmentioning

confidence: 77%

“…Dental and maxillofacial cone-beam CT procedures should not exceed the dose of comparable CT procedures for high-contrast objects (typical CTDI vol < 10 mGy). (232) When used to guide biopsies, cone-beam CT can reduce patient dose and improve targeting accuracy compared with conventional CT (Abi-Jaoudeh et al., 2016). Cone-beam CT is also becoming increasingly important during interventional fluoroscopy procedures (Wallace et al., 2008; Lightfoot et al., 2013; Corredoira et al., 2015). It can provide information and guidance that is not otherwise available during the procedure, and can increase the safety of the procedure (Lee et al., 2014).…”

Section: Digital Radiography Computed Tomography Nuclear Medicinmentioning

confidence: 99%

“…The portion of the radiation used for the procedure that is due to cone-beam CT can be substantial. Corredoira et al. (2015) analysed the total P KA measured in paediatric interventional cardiology procedures, and observed that cone-beam CT contributed 33% of the radiation used in therapeutic procedures and 16% of the radiation used in diagnostic procedures.…”

Section: Digital Radiography Computed Tomography Nuclear Medicinmentioning

confidence: 99%

See 2 more Smart Citations

ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging

Vañó¹,

Miller²,

Martin³

et al. 2017

Ann ICRP

622

383

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The International Commission on Radiological Protection (ICRP) first introduced the term ‘diagnostic reference level’ (DRL) in 1996 in Publication 73. The concept was subsequently developed further, and practical guidance was provided in 2001. The DRL has been proven to be an effective tool that aids in optimisation of protection in the medical exposure of patients for diagnostic and interventional procedures. However, with time, it has become evident that additional advice is needed. There are issues related to definitions of the terms used in previous guidance, determination of the values for DRLs, the appropriate interval for re-evaluating and updating these values, appropriate use of DRLs in clinical practice, methods for practical application of DRLs, and application of the DRL concept to newer imaging technologies. This publication is intended as a further source of information and guidance on these issues. Some terminology has been clarified. In addition, this publication recommends quantities for use as DRLs for various imaging modalities, and provides information on the use of DRLs for interventional procedures and in paediatric imaging. It suggests modifications in the conduct of DRL surveys that take advantage of automated reporting of radiation-dose-related quantities, and highlights the importance of including information on DRLs in training programmes for healthcare workers. The target audience for this publication is national, regional, and local authorities; professional societies; and facilities that use ionising radiation for medical purposes, and responsible staff within these facilities. A full set of the Commission’s recommendations is provided.

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Section: Interventional Proceduresmentioning

confidence: 77%

Section: Digital Radiography Computed Tomography Nuclear Medicinmentioning

confidence: 99%

Section: Digital Radiography Computed Tomography Nuclear Medicinmentioning

confidence: 99%

See 1 more Smart Citation

ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging

Vañó¹,

Miller²,

Martin³

et al. 2017

Ann ICRP

622

383

View full text Add to dashboard Cite

show abstract

“…However, most articles reported that 3DRA also had equal [3, 9, 14, 19, 21, 24] or less contrast and radiation exposure when compared to CA, even when interventions were performed [4, 17, 18]. To add to that, some studies even indicate that the doses can be further diminished by reducing the frame rate and by getting better acquainted with the equipment [10, 22, 27]. Besides, many articles admitted to a learning curve causing higher contrast and radiation exposure at the start, which dropped after getting more familiar with the technique or after having consulted a technician from the corresponding 3DRA vendor [4, 6, 8, 9, 13, 22].…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Rotational Angiography in Pediatric Patients with Congenital Heart Disease: A Literature Review

et al. 2019

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Cardiac catheterization is a commonly used form of imaging and treatment in pediatric patients with congenital heart disease. Traditionally, two-dimensional conventional angiography was the method used, but since 2000 three-dimensional rotational angiography (3DRA) is increasingly used in the field of cardiology in both adult and pediatric patients. To investigate the use and applications of 3DRA in pediatric congenital cardiology, literature was systematically reviewed and 29 eligible articles were found. Those showed that 3DRA is already a greatly valued diagnostic and therapeutic technique in pediatric cardiology. However, the literature misses well-designed clinical, homogeneous, multicenter, prospective studies recording data in a standardized manner. These studies are necessary to ensure proper data analysis and to investigate the true advantages of 3DRA and how it exactly benefits the patients.

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“…This part of the commissioning testing sets the baseline values as a reference for future routine quality control tests (constancy tests) to monitor the most significant system operation parameters to ensure their stability over time. (2,3,6) A recent study that included 756 pediatric cardiac catheterization procedures concluded that the percentage increases in the median value of the air kerma‐area product due to CBCT were 33% and 16% for diagnostic and therapeutic procedures, respectively (7) To improve optimization and properly manage patient doses with sufficient diagnostic‐quality imaging, knowledge of the equipment's performance is necessary. This report presents the results of the physical characterization conducted as part of the commissioning of a biplane angiography system dedicated to pediatric interventional cardiology (IC), including the 3D‐RA mode as one of the imaging options.…”

Section: Introductionmentioning

confidence: 99%

Biplane interventional pediatric system with cone‐beam CT: dose and image quality characterization for the default protocols

Corredoira

Vañó

Alejo

et al. 2016

J Applied Clin Med Phys

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The aim of this study was to assess image quality and radiation dose of a biplane angiographic system with cone‐beam CT (CBCT) capability tuned for pediatric cardiac procedures. The results of this study can be used to explore dose reduction techniques. For pulsed fluoroscopy and cine modes, polymethyl methacrylate phantoms of various thicknesses and a Leeds TOR 18‐FG test object were employed. Various fields of view (FOV) were selected. For CBCT, the study employed head and body dose phantoms, Catphan 504, and an anthropomorphic cardiology phantom. The study also compared two 3D rotational angiography protocols. The entrance surface air kerma per frame increases by a factor of 3–12 when comparing cine and fluoroscopy frames. The biggest difference in the signal‐to‐noise ratio between fluoroscopy and cine modes occurs at FOV 32 cm because fluoroscopy is acquired at a 1440×1440 pixel matrix size and in unbinned mode, whereas cine is acquired at 720×720 pixels and in binned mode. The high‐contrast spatial resolution of cine is better than that of fluoroscopy, except for FOV 32 cm, because fluoroscopy mode with 32 cm FOV is unbinned. Acquiring CBCT series with a 16 cm head phantom using the standard dose protocol results in a threefold dose increase compared with the low‐dose protocol. Although the amount of noise present in the images acquired with the low‐dose protocol is much higher than that obtained with the standard mode, the images present better spatial resolution. A 1 mm diameter rod with 250 Hounsfield units can be distinguished in reconstructed images with an 8 mm slice width. Pediatric‐specific protocols provide lower doses while maintaining sufficient image quality. The system offers a novel 3D imaging mode. The acquisition of CBCT images results in increased doses administered to the patients, but also provides further diagnostic information contained in the volumetric images. The assessed CBCT protocols provide images that are noisy, but with very good spatial resolution.PACS number(s): 87.59.‐e, 87.59.‐C, 87.59.‐cf, 87.59.Dj, 87.57. uq

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Patient doses in paediatric interventional cardiology: impact of 3D rotational angiography

Cited by 24 publications

References 15 publications

ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging

ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging

Three-Dimensional Rotational Angiography in Pediatric Patients with Congenital Heart Disease: A Literature Review

Biplane interventional pediatric system with cone‐beam CT: dose and image quality characterization for the default protocols

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