Estimation of radiation dose and risk to children undergoing cardiac catheterization for the treatment of a congenital heart disease using Monte Carlo simulations

Abstract

Background: Children diagnosed with congenital heart disease often undergo cardiac catheterization for their treatment, which involves the use of ionizing radiation and therefore a risk of radiation-induced cancer.

Objective: The purpose of this study was to calculate the effective and equivalent organ doses (H(T)) in those children and estimate the risk of exposure-induced death.

Materials and methods: Fifty-three children were divided into three groups: atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA). In all procedures, the exposure conditions and the dose-area product meters readings were recorded for each individual acquisition. Monte Carlo simulations were run using the PCXMC 2.0 code and mathematical phantoms simulating a child's anatomy. The H(T) values to all irradiated organs and the resulting E and risk of exposure-induced death values were calculated.

Results: The average dose-area product values were, respectively, 40 ± 12 Gy·cm(2) for the ASD, 17.5 ± 0.7 Gy·cm(2) for the VSD and 9.5 ± 1 Gy·cm(2) for the PDA group. The average E values were 40 ± 12, 22 ± 2.5 and 17 ± 3.6 mSv for ASD, VSD and PDA groups, respectively. The respective estimated risk of exposure-induced death values per procedure were 0.109, 0.106 and 0.067%.

Conclusion: Cardiac catheterizations in children involve a considerable risk for radiation-induced cancer that has to be further reduced.