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Impact of imaging approach on radiation dose and associated cancer risk in children undergoing cardiac catheterization.

Publication ,  Journal Article
Hill, KD; Wang, C; Einstein, AJ; Januzis, N; Nguyen, G; Li, JS; Fleming, GA; Yoshizumi, TK
Published in: Catheter Cardiovasc Interv
April 2017

OBJECTIVES: To quantify the impact of image optimization on absorbed radiation dose and associated risk in children undergoing cardiac catheterization. BACKGROUND: Various imaging and fluoroscopy system technical parameters including camera magnification, source-to-image distance, collimation, antiscatter grids, beam quality, and pulse rates, all affect radiation dose but have not been well studied in younger children. METHODS: We used anthropomorphic phantoms (ages: newborn and 5 years old) to measure surface radiation exposure from various imaging approaches and estimated absorbed organ doses and effective doses (ED) using Monte Carlo simulations. Models developed in the National Academies' Biological Effects of Ionizing Radiation VII report were used to compare an imaging protocol optimized for dose reduction versus suboptimal imaging (+20 cm source-to-image-distance, +1 magnification setting, no collimation) on lifetime attributable risk (LAR) of cancer. RESULTS: For the newborn and 5-year-old phantoms, respectively ED changes were as follows: +157% and +232% for an increase from 6-inch to 10-inch camera magnification; +61% and +59% for a 20 cm increase in source-to-image-distance; -42% and -48% with addition of 1-inch periphery collimation; -31% and -46% with removal of the antiscatter grid. Compared with an optimized protocol, suboptimal imaging increased ED by 2.75-fold (newborn) and fourfold (5 years old). Estimated cancer LAR from 30-min of posteroanterior fluoroscopy using optimized versus suboptimal imaging, respectively was 0.42% versus 1.23% (newborn female), 0.20% versus 0.53% (newborn male), 0.47% versus 1.70% (5-year-old female) and 0.16% versus 0.69% (5-year-old male). CONCLUSIONS: Radiation-related risks to children undergoing cardiac catheterization can be substantial but are markedly reduced with an optimized imaging approach. © 2016 Wiley Periodicals, Inc.

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Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

April 2017

Volume

89

Issue

5

Start / End Page

888 / 897

Location

United States

Related Subject Headings

  • United States
  • Risk Assessment
  • Radiation Dosage
  • Phantoms, Imaging
  • Neoplasms, Radiation-Induced
  • Male
  • Infant, Newborn
  • Incidence
  • Humans
  • Fluoroscopy
 

Citation

APA
Chicago
ICMJE
MLA
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Hill, K. D., Wang, C., Einstein, A. J., Januzis, N., Nguyen, G., Li, J. S., … Yoshizumi, T. K. (2017). Impact of imaging approach on radiation dose and associated cancer risk in children undergoing cardiac catheterization. Catheter Cardiovasc Interv, 89(5), 888–897. https://doi.org/10.1002/ccd.26630
Hill, Kevin D., Chu Wang, Andrew J. Einstein, Natalie Januzis, Giao Nguyen, Jennifer S. Li, Gregory A. Fleming, and Terry K. Yoshizumi. “Impact of imaging approach on radiation dose and associated cancer risk in children undergoing cardiac catheterization.Catheter Cardiovasc Interv 89, no. 5 (April 2017): 888–97. https://doi.org/10.1002/ccd.26630.
Hill KD, Wang C, Einstein AJ, Januzis N, Nguyen G, Li JS, et al. Impact of imaging approach on radiation dose and associated cancer risk in children undergoing cardiac catheterization. Catheter Cardiovasc Interv. 2017 Apr;89(5):888–97.
Hill, Kevin D., et al. “Impact of imaging approach on radiation dose and associated cancer risk in children undergoing cardiac catheterization.Catheter Cardiovasc Interv, vol. 89, no. 5, Apr. 2017, pp. 888–97. Pubmed, doi:10.1002/ccd.26630.
Hill KD, Wang C, Einstein AJ, Januzis N, Nguyen G, Li JS, Fleming GA, Yoshizumi TK. Impact of imaging approach on radiation dose and associated cancer risk in children undergoing cardiac catheterization. Catheter Cardiovasc Interv. 2017 Apr;89(5):888–897.
Journal cover image

Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

April 2017

Volume

89

Issue

5

Start / End Page

888 / 897

Location

United States

Related Subject Headings

  • United States
  • Risk Assessment
  • Radiation Dosage
  • Phantoms, Imaging
  • Neoplasms, Radiation-Induced
  • Male
  • Infant, Newborn
  • Incidence
  • Humans
  • Fluoroscopy