Δευτέρα 15 Ιανουαρίου 2018

Impact of low dose settings on radiation exposure during pediatric fluoroscopic guided interventions

Publication date: March 2018
Source:European Journal of Radiology, Volume 100
Author(s): Moritz Wildgruber, Michael Köhler, Richard Brill, Holger Goessmann, Wibke Uller, René Müller-Wille, Walter A. Wohlgemuth
PurposeTo evaluate the effects of lowering the detector entrance exposure in children undergoing interventional radiology procedures.Materials and MethodsThe study retrospectively investigated radiation dose levels in pediatric patients aged 0–18 years before (n = 39) and after (n = 26) lowering detector entrance dose, undergoing embolization of peripheral Arteriovenous malformations, Portal Vein Interventions or Percutaneous Transhepatic Cholangio Drainage (PTCD) between 2014 and 2017. Patient characteristics, fluoroscopy time, protocols used as well as resulting Skin Dose and Dose Area Product (DAP) were compared in each cohort. Image quality was assessed by two independent readers.ResultsThe two patient cohorts did not differ in terms of patient demographics. Similarly, fluoroscopy time did not differ before and after implementation of the low dose settings. An overall reduction of skin dose of 75.1% for AVM embolizations, 80.5% for Portal Vein Interventions and 85.3% for PTCD placement was observed. The DAP decrease was 82.5% for AVM embolizations, 72.2% for Portal Vein Interventions and 79.8% for PTCD placement. Image quality was generally considered to be good with an insignificant difference between pre and post implementation of the low dose approach and good agreement between the two readers. Manual inroom-switching to higher dose levels was possible, however this was not performed more frequently after implementation of the low dose settings.ConclusionLowering the detector entrance dose in pediatric interventional radiology procedures results in a significant decrease of the radiation dose burden.



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