Abstract
ABSTRACT: The number of paediatric interventional radiology (IR) procedures being performed has
increased rapidly in recent years. Interventional procedures have been reported to contribute to the highest
doses of radiation to patients from medical examinations. It is imperative that we strive to reduce the
radiation burden to our radiosensitive paediatric patients. Previous work has reported a wide variation of
imaging protocols currently being used in the UK and Ireland. These variations in practice are having a
significant impact on the resultant radiation dose to the patient.
· Aim: To investigate the effect of different scatter removal techniques on radiation dose and associated
DNA damage by quantifying γH2AX-foci as a biomarker of radiation-induced effect.
· Methods: An RCT was implemented in one specialised IR suite in Northern Ireland. Children were imaged
using either: (i) an anti-scatter grid (current departmental protocol), (ii) no anti-scatter grid or, (iii) no anti-
scatter grid and a 15 cm air-gap between the child and the x-ray detector. Dose area product and image
quality were assessed, lifetime attributable cancer risk estimates were calculated and DNA double-strand
breakages quantified using the γH2AX assay.
· Results: Consent was obtained from 70 parents/guardians/children. Patients were randomly allocated into
the 3 different techniques for the examinations performed. Image quality was sufficient for each procedure
performed. Removal of the anti-scatter grid resulted in dose reductions of 20% (no anti-scatter grid) and
30% (15 cm air-gap), DNA double-strand break reductions of 30% (no anti-scatter grid) and 20% (15 cm
air-gap) and a reduction of radiation-induced cancer mortality risk of up to 45%.
· Conclusion: Simple modifications to technique can be easily implemented by the radiographer. It is feasible
to remove the anti-scatter grid resulting in a reduction in DNA damage to the patient. This will ensure the
radiation dose to paediatric patients is kept ALARA without affecting image quality or diagnostic efficacy.
The γH2AX assay may be used for assessment of dose optimisation strategies in children.
increased rapidly in recent years. Interventional procedures have been reported to contribute to the highest
doses of radiation to patients from medical examinations. It is imperative that we strive to reduce the
radiation burden to our radiosensitive paediatric patients. Previous work has reported a wide variation of
imaging protocols currently being used in the UK and Ireland. These variations in practice are having a
significant impact on the resultant radiation dose to the patient.
· Aim: To investigate the effect of different scatter removal techniques on radiation dose and associated
DNA damage by quantifying γH2AX-foci as a biomarker of radiation-induced effect.
· Methods: An RCT was implemented in one specialised IR suite in Northern Ireland. Children were imaged
using either: (i) an anti-scatter grid (current departmental protocol), (ii) no anti-scatter grid or, (iii) no anti-
scatter grid and a 15 cm air-gap between the child and the x-ray detector. Dose area product and image
quality were assessed, lifetime attributable cancer risk estimates were calculated and DNA double-strand
breakages quantified using the γH2AX assay.
· Results: Consent was obtained from 70 parents/guardians/children. Patients were randomly allocated into
the 3 different techniques for the examinations performed. Image quality was sufficient for each procedure
performed. Removal of the anti-scatter grid resulted in dose reductions of 20% (no anti-scatter grid) and
30% (15 cm air-gap), DNA double-strand break reductions of 30% (no anti-scatter grid) and 20% (15 cm
air-gap) and a reduction of radiation-induced cancer mortality risk of up to 45%.
· Conclusion: Simple modifications to technique can be easily implemented by the radiographer. It is feasible
to remove the anti-scatter grid resulting in a reduction in DNA damage to the patient. This will ensure the
radiation dose to paediatric patients is kept ALARA without affecting image quality or diagnostic efficacy.
The γH2AX assay may be used for assessment of dose optimisation strategies in children.
| Original language | English |
|---|---|
| Publication status | Published (in print/issue) - 2022 |
| Event | ANNUAL RADIOLOGY MEETING DUBAI - DUBAI, DUBAI Duration: 26 Oct 2022 → 29 Oct 2022 |
Conference
| Conference | ANNUAL RADIOLOGY MEETING DUBAI |
|---|---|
| Abbreviated title | ARM |
| City | DUBAI |
| Period | 26/10/22 → 29/10/22 |
