Effective radiation dosage of three-dimensional rotational angiography in children

Europace. 2015 Apr;17(4):611-6. doi: 10.1093/europace/euu207. Epub 2014 Aug 28.


Aims: Three-dimensional rotational angiography (3DRA) is a relatively new but promising imaging technique in the paediatric catheterization laboratory. However, data on effective dose (ED) of this technique in children are lacking. The purpose of this study is to provide ED of 3DRA and to correlate this with parameters readily available in daily practice. Furthermore, the effect of dose-reducing techniques is evaluated.

Methods and results: Effective doses were calculated with Monte Carlo PCXMC 2.0 in 14 patients who underwent a total of 17 3DRAs at our paediatric catheterization laboratory. Median age was 5.7 years (range 1 day-16.6 years). Median ED was 1.6 milliSievert (mSv) (range 0.7-4.9). Effective dose did not correlate with age and body surface area but did correlate with dose area product (DAP) and milliGray (mGy) with r(2) of 0.75 and 0.83, respectively. Reduction of the total amount of frames from 248 to 133 per rotation resulted in further dose reduction of over 50% with preserved image quality.

Conclusion: The median ED of 3DRA in children is 1.6 mSv and correlates with DAP and mGy. This dose can be halved by applying frame reduction. A significant further dose reduction can be achieved by obtaining additional knowledge of the equipment used.

Keywords: Angiography; Congenital heart disease; Image-guided intervention; Interventional radiology; Radiation dosing.

MeSH terms

  • Adolescent
  • Angiography / methods*
  • Child
  • Child, Preschool
  • Computer Simulation
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Infant
  • Infant, Newborn
  • Male
  • Models, Biological
  • Radiation Dosage*
  • Radiation Exposure / analysis*
  • Radiation Protection / methods*
  • Radiometry / methods*
  • Relative Biological Effectiveness
  • Reproducibility of Results
  • Sensitivity and Specificity