Radiation safety in pediatric interventional radiology: Step Lightly.
ABSTRACT The "Step Lightly" campaign, launched in 2009, is the next phase of the "Image Gently" social marketing campaign, and focuses on improving radiation safety during pediatric interventional radiology procedures. Downloadable content available on the Image Gently website includes parent-friendly information about radiation dose, protocol suggestions and procedure checklists for providers, and information for referring physicians, radiologic technologists and physicists. There are also links to additional reading material and to other relevant organizations.
SourceAvailable from: Roberto Miraglia[Show abstract] [Hide abstract]
ABSTRACT: Background Ultrasound-guided central venous puncture and fluoroscopic guidance during central venous catheter (CVC) positioning optimizes technical success and lowers the complication rates in children, and is therefore considered standard practice. Objective The purpose of this study was to compare the radiation exposure levels recorded during CVC placement in children weighing less than 10 kg in procedures performed using an image intensifier-based angiographic system (IIDS) to those performed in a flat-panel detector-based interventional suite (FPDS). Materials and methods A retrospective review of 96 image-guided CVC placements, between January 2008 and October 2013, in 49 children weighing less than 10 kg was performed. Mean age was 8.2 ± 4.4 months (range: 1-22 months). Mean weight was 7.1 ± 2.7 kg (range: 2.5-9.8 kg). The procedures were classified into two categories: non-tunneled and tunneled CVC placement. Results Thirty-five procedures were performed with the IIDS (21 non-tunneled CVC, 14 tunneled CVC); 61 procedures were performed with the FPDS (47 non-tunneled CVC, 14 tunneled CVC). For non-tunneled CVC, mean DAP was 113.5 ± 126.7 cGy cm2 with the IIDS and 15.9 ± 44.6 cGy · cm2 with the FPDS (P 2 with the IIDS and 37.1 ± 33.5 cGy cm2 with the FPDS (P = 0.02). Conclusion The use of flat-panel angiographic equipment reduces radiation exposure in small children undergoing image-guided CVC placement.Pediatric Radiology 09/2014; 45(2). DOI:10.1007/s00247-014-3119-5 · 1.65 Impact Factor
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ABSTRACT: To measure and compare individual staff radiation dose levels during interventional radiologic (IR) procedures with and without real-time feedback to evaluate whether it has any impact on staff radiation dose. A prospective trial was performed in which individuals filling five different staff roles wore radiation dosimeters during all IR procedures during two phases: a 12-week "closed" phase (measurements recorded but display was off, so no feedback was provided) and a 17-week "open" phase (display was on and provided real-time feedback). Radiation dose rates were recorded and compared by Mann-Whitney U test. There was no significant difference in median procedure time, fluoroscopy time, or patient dose (dose-area product normalized to fluoroscopy time) between the two phases. Overall, the median staff dose was lower in the open phase (0.56 µSv/min of fluoroscopy time) than in the closed phase (3.01 µSv/min; P < .05). The IR attending physician dose decreased significantly for procedures for which the physicians were close to the patient, but not for ones for which they were far away. A radiation dose monitoring system that provides real-time feedback to the interventional staff can significantly reduce radiation exposure to the primary operator, most likely by increasing staff compliance with use of radiation protection equipment and dose reduction techniques.Journal of vascular and interventional radiology: JVIR 10/2013; 25(1). DOI:10.1016/j.jvir.2013.08.015 · 2.15 Impact Factor
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ABSTRACT: Various vascular and nonvascular hepatobiliary interventional radiology techniques are now commonly performed in children's hospitals. Although the procedures are broadly similar to interventional practice in adults, there are important differences in indications and technical aspects. This review describes the indications, techniques, and results of liver biopsy, hepatic and portal venous interventions and biliary interventions in children.CardioVascular and Interventional Radiology 08/2013; 37(1). DOI:10.1007/s00270-013-0712-1 · 1.97 Impact Factor