Radiation Reduction Capabilities of a Next-Generation Pediatric Imaging Platform

Abstract

The aims of this study were to quantify patient radiation exposure for a single interventional procedure during transition from an adult catheterization laboratory to a next-generation imaging system with pediatric settings, and to compare this radiation data to published benchmarks. Radiation exposure occurs with any X-ray-directed pediatric catheterization. Technologies and imaging techniques that limit dose while preserving image quality benefit patient care. Patient radiation dose metrics, air kerma, and dose-area product (DAP) were retrospectively obtained for patients <20 kg who underwent patent ductus arteriosus (PDA) closure on a standard imaging system (Group 1, n = 11) and a next-generation pediatric imaging system (Group 2, n = 10) with air-gap technique. Group 2 radiation dose metrics were then compared to published benchmarks. Patient demographics, procedural technique, PDA dimensions, closure devices, and fluoroscopy time were similar for the two groups. Air kerma and DAP decreased by 65-70% in Group 2 (p values <0.001). The average number of angiograms approached statistical significance (p value = 0.06); therefore, analysis of covariance (ANCOVA) was conducted that confirmed significantly lower dose measures in Group 2. This degree of dose reduction was similar when Group 2 data (Kerma 28 mGy, DAP 199 µGy m(2)) was compared to published benchmarks for PDA closure (Kerma 76 mGy, DAP 500 µGy m(2)). This is the first clinical study documenting the radiation reduction capabilities of a next-generation pediatric imaging platform. The true benefit of this dose reduction will be seen in patients requiring complex and often recurrent catheterizations.

Keywords: Angiography; Pediatric catheterization; Radiation reduction.