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

被引:5
作者
Gould, Richard [1 ]
McFadden, Sonyia L. [1 ]
Sands, Andrew J. [2 ]
McCrossan, Brian A. [2 ]
Horn, Simon [3 ]
Prise, Kevin M. [3 ]
Doyle, Philip [4 ]
Hughes, Ciara M. [1 ]
机构
[1] Ulster Univ, Inst Nursing & Hlth Res, Jordanstown Campus,Shore Rd, Newtownabbey, North Ireland
[2] Royal Belfast Hosp Sick Children, 274 Grosvenor Rd, Belfast, Antrim, North Ireland
[3] Queens Univ Belfast, Ctr Canc Res & Cell Biol, 97 Lisburn Rd, Belfast, Antrim, North Ireland
[4] Belfast Hlth & Social Care Trust, Foster Green Hosp, Reg Med Phys Serv, 110 Saintfield Rd, Belfast, Antrim, North Ireland
关键词
paediatric cardiac catheterisation; radiation dose optimisation; DNA double-strand breakage; risk of ionising radiation; stochastic effects; STRAND BREAK REPAIR; CONGENITAL HEART-DISEASE; GAMMA-H2AX FOCI; IMAGE QUALITY; INTERVENTIONAL CARDIOLOGY; DOSE REDUCTION; LARGE-VOLUME; LYMPHOCYTES; EXPOSURE; OPTIMIZATION;
D O I
10.1088/1361-6498/aa80a4
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
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 gamma H2AX 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 gamma H2AX assay may be used for assessment of dose optimisation strategies in children.
引用
收藏
页码:742 / 760
页数:19
相关论文
共 44 条
[1]  
[Anonymous], 2007, ICRP PUBL, V37
[2]   Patient-specific dose and radiation risk estimation in pediatric cardiac catheterization [J].
Bacher, K ;
Bogaert, E ;
Lapere, R ;
De Wolf, D ;
Thierens, H .
CIRCULATION, 2005, 111 (01) :83-89
[3]   Local Reference Levels and Organ Doses From Pediatric Cardiac Interventional Procedures [J].
Barnaoui, S. ;
Rehel, J. L. ;
Baysson, H. ;
Boudjemline, Y. ;
Girodon, B. ;
Bernier, M. O. ;
Bonnet, D. ;
Aubert, B. .
PEDIATRIC CARDIOLOGY, 2014, 35 (06) :1037-1045
[4]   γ-H2AX Foci as a Biomarker for Patient X-Ray Exposure in Pediatric Cardiac Catheterization Are We Underestimating Radiation Risks? [J].
Beels, Laurence ;
Bacher, Klaus ;
De Wolf, Daniel ;
Werbrouck, Joke ;
Thierens, Hubert .
CIRCULATION, 2009, 120 (19) :1903-1909
[5]  
BEIR V, 2006, HLTH RISK EXPOSURE L
[6]   Influence of Different Antioxidants on X-Ray Induced DNA Double-Strand Breaks (DSBs) Using γ-H2AX Immunofluorescence Microscopy in a Preliminary Study [J].
Brand, Michael ;
Sommer, Matthias ;
Ellmann, Stephan ;
Wuest, Wolfgang ;
May, Matthias S. ;
Eller, Achim ;
Vogt, Sabine ;
Lell, Michael M. ;
Kuefner, Michael A. ;
Uder, Michael .
PLOS ONE, 2015, 10 (05)
[7]  
Cousins C, 2012, ICRP PUBL, V42
[8]   Dose and image quality optimization in neonatal radiography [J].
Dougeni, E. D. ;
Delis, H. B. ;
Karatza, A. A. ;
Kalogeropoulou, C. P. ;
Skiadopoulos, S. G. ;
Mantagos, S. P. ;
Panayiotakis, G. S. .
BRITISH JOURNAL OF RADIOLOGY, 2007, 80 (958) :807-815
[9]   Radiation Dose Benchmarks During Cardiac Catheterization for Congenital Heart Disease in the United States [J].
Ghelani, Sunil J. ;
Glatz, Andrew C. ;
David, Sthuthi ;
Leahy, Ryan ;
Hirsch, Russel ;
Armsby, Laurie B. ;
Trucco, Sara M. ;
Holzer, Ralf J. ;
Bergersen, Lisa .
JACC-CARDIOVASCULAR INTERVENTIONS, 2014, 7 (09) :1060-1069
[10]   Dose optimization in pediatric cardiac x-ray imaging [J].
Gislason, Amber J. ;
Davies, Andrew G. ;
Cowen, Arnold R. .
MEDICAL PHYSICS, 2010, 37 (10) :5258-5269