Removal of scatter radiation in paediatric cardiac catheterisation: a randomised controlled clinical trial.

Richard Gould, S. L. McFadden, Andrew Sands, Brian McCrossan, Simon Horn, Kevin Prise, Philip Doyle, Ciara Hughes

Research output: Contribution to journalArticle

Abstract

Objective: This study sought to determine if DNA integrity was compromised by ionising radiation from paediatric cardiac catheterisations and if dose optimisation techniques allowed DNA integrity to be maintained. Materials and Methods: 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. 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: Radiation doses received during paediatric cardiac catheterisation procedures resulted in a significant increase in DNA damage while maintaining acceptable image quality and diagnostic efficacy. It is feasible to remove the anti-scatter grid resulting in a reduction in DNA damage to the patient. The γH2AX assay may be used for assessment of dose optimisation strategies in children.
LanguageEnglish
Pages742
Number of pages760
JournalJournal of Radiological Protection
Volume1
Publication statusAccepted/In press - 19 Jul 2017

Fingerprint

Cardiac Catheterization
Randomized Controlled Trials
Radiation
Pediatrics
DNA
Air
DNA Damage
Radiation-Induced Neoplasms
Double-Stranded DNA Breaks
air
Ionizing Radiation
assay
mortality risk
damage
Parents
X-Rays
breakage
Mortality
radiation
removal

Keywords

  • radiation dose
  • interventional cardiology
  • radiology
  • scatter reduction
  • children

Cite this

Gould, Richard ; McFadden, S. L. ; Sands, Andrew ; McCrossan, Brian ; Horn, Simon ; Prise, Kevin ; Doyle, Philip ; Hughes, Ciara. / Removal of scatter radiation in paediatric cardiac catheterisation: a randomised controlled clinical trial. In: Journal of Radiological Protection. 2017 ; Vol. 1. pp. 742.
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abstract = "Objective: This study sought to determine if DNA integrity was compromised by ionising radiation from paediatric cardiac catheterisations and if dose optimisation techniques allowed DNA integrity to be maintained. Materials and Methods: 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. 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: Radiation doses received during paediatric cardiac catheterisation procedures resulted in a significant increase in DNA damage while maintaining acceptable image quality and diagnostic efficacy. It is feasible to remove the anti-scatter grid resulting in a reduction in DNA damage to the patient. The γH2AX assay may be used for assessment of dose optimisation strategies in children.",
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Removal of scatter radiation in paediatric cardiac catheterisation: a randomised controlled clinical trial. / Gould, Richard; McFadden, S. L.; Sands, Andrew; McCrossan, Brian; Horn, Simon; Prise, Kevin; Doyle, Philip; Hughes, Ciara.

In: Journal of Radiological Protection, Vol. 1, 19.07.2017, p. 742.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Removal of scatter radiation in paediatric cardiac catheterisation: a randomised controlled clinical trial.

AU - Gould, Richard

AU - McFadden, S. L.

AU - Sands, Andrew

AU - McCrossan, Brian

AU - Horn, Simon

AU - Prise, Kevin

AU - Doyle, Philip

AU - Hughes, Ciara

PY - 2017/7/19

Y1 - 2017/7/19

N2 - Objective: This study sought to determine if DNA integrity was compromised by ionising radiation from paediatric cardiac catheterisations and if dose optimisation techniques allowed DNA integrity to be maintained. Materials and Methods: 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. 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: Radiation doses received during paediatric cardiac catheterisation procedures resulted in a significant increase in DNA damage while maintaining acceptable image quality and diagnostic efficacy. It is feasible to remove the anti-scatter grid resulting in a reduction in DNA damage to the patient. The γH2AX assay may be used for assessment of dose optimisation strategies in children.

AB - Objective: This study sought to determine if DNA integrity was compromised by ionising radiation from paediatric cardiac catheterisations and if dose optimisation techniques allowed DNA integrity to be maintained. Materials and Methods: 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. 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: Radiation doses received during paediatric cardiac catheterisation procedures resulted in a significant increase in DNA damage while maintaining acceptable image quality and diagnostic efficacy. It is feasible to remove the anti-scatter grid resulting in a reduction in DNA damage to the patient. The γH2AX assay may be used for assessment of dose optimisation strategies in children.

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KW - interventional cardiology

KW - radiology

KW - scatter reduction

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JF - Journal of Radiological Protection

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