Radiation dose optimisation in paediatric interventional cardiology

Abstract

The aim of the thesis was to investigate radiation doses in paediatric interventional cardiology (IC). A literature review was performed which highlighted a low level of research in paediatric IC. A radiation dose survey was performed investigating radiation doses during paediatric IC in two specialised paediatric hospitals which produced a number of key findings. Wide variation in radiation dose was recorded between two different clinic centres performing the same IC procedures. When investigated further it was revealed that the two clinical centres use different protocols to carry out the same procedure on the same size of patient. The results of the prospective survey were used to calculate local diagnostic reference levels in paediatric IC by age and weight groupings. A questionnaire study was carried out on all paediatric IC departments in the UK and Ireland. Analysis of responses showed that although IC procedures share common techniques the radiographic protocol varied greatly from one hospital to another. The results of the questionnaire informed experimental studies which simulated the IC procedures on tissue equivalent paediatric phantoms. The variations in protocol identified from the questionnaire were introduced to the experimental study and the resultant effect on radiation dose and image quality was recorded. The results showed that simple modifications can be made to the radiographic protocol during paediatric IC procedures which will give a minimum dose reduction of 27.6% without affecting image quality. This thesis adds to the limited evidence base and makes recommendations for clinicians to introduce into their clinical practice which will help keep the radiation dose to a minimum in paediatric IC.

Date of Award	Sept 2009
Original language	English
Supervisor	John Winder (Supervisor) & Ciara Hughes (Supervisor)