Setting up regional diagnostic reference levels for pediatric computed tomography in Latin America: preliminary results, challenges and the work ahead.

We established a framework for collecting radiation doses for head, chest and abdomen-pelvis computed tomography (CT) in children scanned at multiple imaging sites across Latin America with an aim towards establishing diagnostic reference levels (DRLs) and achievable doses (ADs) in pediatric CT in Latin America. Our study included 12 Latin American sites (in Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Honduras and Panama) contributing data on the four most common pediatric CT examinations (non-contrast head, non-contrast chest, post-contrast chest and post-contrast abdomen-pelvis). Sites contributed data on patients' age, sex and weight, scan factors (tube current and potential), volume CT dose index (CTDIvol) and dose length product (DLP). Data were verified, leading to the exclusion of two sites with missing or incorrect data entries. We estimated overall and site-specific 50th (AD) and 75th (diagnostic reference level [DRL]) percentile CTDIvol and DLP for each CT protocol. Non-normal data were compared using the Kruskal-Wallis test. Sites contributed data from 3,934 children (1,834 females) for different CT exams (head CT 1,568/3,934, 40%; non-contrast chest CT 945/3,934, 24%; post-contrast chest CT 581/3,934, 15%; abdomen-pelvis CT 840/3,934, 21%). There were significant statistical differences in 50th and 75th percentile CTDIvol and DLP values across the participating sites (P<0.001). The 50th and 75th percentile doses for most CT protocols were substantially higher than the corresponding doses reported from the United States of America. Our study demonstrates substantial disparities and variations in pediatric CT examinations performed in multiple sites in Latin America. We will use the collected data to improve scan protocols and perform a follow-up CT study to establish DRLs and ADs based on clinical indications.

Embolización transcatéter / Transcatheter Embolization

Emboloterapia, embolización o embolización transcatéter son nombres que actualmente se le asignan al mismo procedimiento, conocido desde comienzos del siglo XX, que tomó fuerza y se difundió desde principios de 1970 cuando se impulsó su aplicación por medio de catéteres. Desde entonces, la evolución de las técnicas y el continuo desarrollo de materiales han convertido esta terapia en una herramienta de utilidad excepcional en el control de la hemorragia y el tratamiento de diferentes neoplasias.

Embolotherapy, embolization or transcatheter embolization are names that today are assigned for the same procedure, known since the early twentieth century and that took force spreading from the beginning of the 1970s when its application was promoted through catheters. Since then the evolution of techniques and the continuous development of materials have made this technique an exceptional tool in the control of hemorrhage and treatment of different neoplasms.