ABSTRACT
The aim of this work was to establish local diagnostic reference levels (DRLs) for retrograde wedge portography (RWP) performed on pediatric patients assessing the usefulness of radiation dose monitoring software in the establishing process. Between September 2016 and April 2020, 66 consecutive RWP were performed at a transplantation institute and were included in our study. Patients were divided in three groups according to age: n = 25 infants, n = 20 middle childhood and n = 21 early adolescence. The third quartile of both Air Kerma at the reference point (Ka,r) and air kerma-area product (PKA) were evaluated to establish local DRLs (lDRLs). In addition, to control high Ka,r levels during procedures, the software notified to operators if Ka,r exceeded the dose 'alert' threshold set at 2 Gy. lDRLs were established for all three groups using PKA and Ka,r: infant group: 5.6 Gy.cm 2 and 0.034 Gy; middle childhood: 6.4 Gy.cm2 and 0.018 Gy and early adolescence: 12.8 Gy.cm2 and 0.059 Gy. The dose threshold 'alert' was never encountered (alert quota: 0%). The dose monitoring system supports the feasibility of accurate and easier lDRLs' establishment.
Subject(s)
Diagnostic Reference Levels , Portography , Adolescent , Adult , Child , Fluoroscopy , Humans , Infant , Radiation Dosage , SoftwareABSTRACT
We report three cases of clinically necessary, fluoroscopy-guided, percutaneous biliary procedures performed safely in a pregnant, liver transplant recipient using three different angiography suites. The uterine cumulative equivalent dose was 0.25 mSv, a value obtained by adding the doses of the three procedures described above, and which is relatively low when compared with the naturally occurring background radiation exposure for a 9-month pregnancy (~0.5-1 mSv). Our experience shows that staff knowledge, awareness and liaison promote the application of all dose reduction strategies possible while still achieving the clinical aim despite using different angiographic equipment.
