日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Background: Radiation exposure doses during pediatric catheterization may be effectively compared using dose area product per body weight (DAP/BW). Hence, we used DAP/BW to determine the effects of radiation dose reduction caused by era and technology change.

Methods: This study included 2757 patients (＜15 years old) who underwent cardiac catheterization at our institute between 2008 and 2019. The procedure included transcatheter atrial septal defect closure (Group A; n＝107), balloon dilatation for pulmonary stenosis (BAP) (Group B; n＝117), coil embolization for aortopulmonary collateral arteries (Group C; n＝395), diagnostic procedures (Group D; n＝1918), and radiofrequency ablation (Group R; n＝220). We compared the radiation doses during three time periods (period 1, 2008–2011; period 2, 2012–2016; period 3, 2017–2019).

Results: The DAP/BW levels decreased in Groups A and R at time period 3 (Group A: 1, 13.5; 2, 13.5; 3, 9.8; p＜0.05; Group R: 1, 51.6; 2, 33.4; 3, 20.5; p＜0.05). The DAP/BW in Group C remained unchanged. In Groups B and D, the DAP/BW was highest in period 3 (Group B: 1, 76.8; 2, 108.5; 3, 117.0; p＜0.05; Group D: 1, 41.0; 2, 45.1; 3, 46.0; p＜0.05).

Conclusion: In Groups A and R, radiation doses were reduced by changes in technology and experience. In Groups B and D, the radiation doses increased because of the complexity of the lesion or anatomy. Therefore, DAP/BW can be an indicator of radiation dose reduction in pediatric cardiac catheterizations.