Effective Dose of Radiation in Diagnostic and Interventional Cardiac Angiography among Pediatrics and Adolescents in Hospitals of Shiraz University of Medical Sciences versus Other Radiology Devices

Cardiac catheterization and angiography are diagnostic and therapeutic imaging modalities that produce the highest X-ray radiation, which might impose lifelong risks to patients. This study aimed to evaluate radiation burden among children and adolescents with congenital heart diseases, who underwent cardiac catheterization and angiography. Then the results were compared with other imaging modalities.

In this prospective study, children and adolescents with congenital heart diseases were consecutively evaluated from April 2017 till November 2017. This research was designed in Namazi and Faghihi teaching hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. In addition to the basic data and total radiation time, effective dose and dose area product were assessed for each patient.

We enrolled 148 consecutive patients under 18 years old, who underwent 36 diagnostic and 112 interventional cardiac catheterizations. Effective dose was 50.23 mGy in the diagnostic catheterizations, and 48.39 mGy in the interventional angiographies. Also the dose area product was 427/28 mGy.cm2 in the diagnostic catheterizations, and 476.62 mGy.cm2 in the interventional angiography. The most time-consuming cine fluoroscopy pertained to ventricular septal defect closure and (11.67seconds) and the most effective dose and dose area product pertained to the same procedure, as well (68,514 mGy and 623,843 mGy.cm2 respectively).

Effective dose and dose area product in cardiac catheterization were desirable, and some
previous studies revealed that carcinogenic effect of X-ray radiation is more prominent when effective dose is more than 70-100 mGy. Thus the effective dose might not cause hazardous outcomes if other x ray
modalities are not frequently requested for them in future.