Implementing Patient Protection Radiation Dose Alerts for Pediatric Cardiac Catheterization Examinations.

Abstract

Background: Advancements in cardiac catheterization have improved survival for pediatric congenital heart disease patients, but the associated ionizing radiation risks necessitate ethical consideration.

Methods: This study presents an empirical model, developed from 3131 unique pediatric procedures, to establish alert levels based on a patient's lateral thickness of the thorax for various procedural categories during diagnostic or interventional cardiac catheterization. The model uses linear regression of logarithmic reference air kinetic energy released per unit mass (KERMA) and air KERMA area product, also referred to as dose area product, to set alert levels at the top 95% and 99% of patient data.

Results: Coefficients of the regression fits are provided for diagnostic and interventional procedural groups and fluoroscopic plane allowing any facility to scale the results of this study's single facility data to model their practice's unique procedural dose levels.

Conclusions: The proposed method allows institutions to tailor dose alert levels to their specific pediatric populations to reduce overexposure events.