2010
DOI: 10.1007/s00246-010-9770-1
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X-Ray Dose from Pediatric Cardiac Catheterization: A Comparison of Materials and Methods for Measurement or Calculation

Abstract: Pediatric cardiac catheterization procedures have the potential to transmit high X-ray doses, which may lead to acute effects or latent skin reactions. Direct measurement of radiation dose was facilitated using nanodot dosimeters and radiochromic film. Direct measurement results were compared with vendor-listed dosimetry and calculation using phantom data. Vendor-listed data demonstrated a wide discrepancy with measured data, whereas the calculation reproducibly overestimated the actual dose. A simple formula … Show more

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Cited by 4 publications
(5 citation statements)
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“…Prospective direct measurement of PSD during fluoroscopically-guided interventions is a complicated and time-consuming task. A number of attempts have been made to relate indirect dose metrics and calculated quantities to direct measurements of PSD, [4][5][6][7][8][9][10][11] with the authors of these works using widely varying methods for calculating PSD from indirect metrics including reference air kerma and kerma area product (KAP), and with one exception using film to directly measure PSD. It is difficult to make meaningful comparisons between these studies owing to the different calculation methods used and because film calibration methods were not always reported.…”
Section: Introductionmentioning
confidence: 99%
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“…Prospective direct measurement of PSD during fluoroscopically-guided interventions is a complicated and time-consuming task. A number of attempts have been made to relate indirect dose metrics and calculated quantities to direct measurements of PSD, [4][5][6][7][8][9][10][11] with the authors of these works using widely varying methods for calculating PSD from indirect metrics including reference air kerma and kerma area product (KAP), and with one exception using film to directly measure PSD. It is difficult to make meaningful comparisons between these studies owing to the different calculation methods used and because film calibration methods were not always reported.…”
Section: Introductionmentioning
confidence: 99%
“…It is difficult to make meaningful comparisons between these studies owing to the different calculation methods used and because film calibration methods were not always reported. The results of these studies were equally variable, including findings of a coefficient of determination of 0.8 between reference air kerma and PSD for endovascular thoracoabdominal aneurysm repair; 4 that reference air kerma overestimated measured PSD for low doses and was within 50% for doses greater than 1 Gy; 5 a measured PSD that was 21% lower than reference air kerma for a single patient; 6 that manufacturer-reported reference air kerma was an "unreliable predictor of actual dose" when using visual comparison of a preprinted calibration tablet to film for pediatric cardiac catheterization; 7 and that in about half of 16 cases, reference air kerma overestimated the PSD. 8 Recently, the following statement appeared in a review of radiation effects on patients' skin and hair: "Skin dosimetry is unlikely to be more accurate than ±50%" (Ref.…”
Section: Introductionmentioning
confidence: 99%
“…Our findings are consistent with a prior study by Herron et al . [ 13 ] Their study is focused on deriving a formula to calculate radiation dose in children during cardiac catheterization from fluoroscopy time, average cine mA and number of exposed frames. We analyzed parts of their published raw data to correlate Nanodot-derived values with manufacturer's display values for AK, and derived linear correlation formula (y = 0.57x + 70) and R 2 = 0.84 that are consistent with our findings except for a higher intercept (70 compared to 7.8).…”
Section: Discussionmentioning
confidence: 99%
“…[ 12 ] Nanodots are based on optically-stimulated luminescence (OSL) dosimetry as opposed to the more commonly-used thermo-luminescence dosimetry (TLD) method. [ 13 ] Each Nanodot is prescreened by the manufacturer for variation in crystal sensitivity and adjusted to be within 2% between Nanodots and is supplied with a unique serial number and bar code.…”
Section: Methodsmentioning
confidence: 99%
“…Even though the long-term risks of fatal malignancy following a single pediatric catheter investigation seems very low, the effect of repetitive exposure is unclear [7], [31]. In general, DAP values measured during pediatric catheterizations show an excellent correlation with the entrance radiation dose and skin doses measured with thermoluminescent dosemeters (TLDs) or can be transferred by calculation models to effective doses and are therefore valid to obtain a real-time measurement of the total amount of radiation used [4], [13], [32], [33], [34], [35]. Similar results are obtained when calculating effective doses from DAP as published by the International Commission on Radiology Protection and measuring the effects on DNA damage [8].…”
Section: Discussionmentioning
confidence: 99%