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New Optimization Strategies on Radiation Protection in Fluoroscopy-Guided Interventional Procedures...
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New Optimization Strategies on Radiation Protection in Fluoroscopy-Guided Interventional Procedures in Pediatrics

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Cardiology".

Deadline for manuscript submissions: 1 December 2024 | Viewed by 5136

Special Issue Editor

Dr. Carlos Ubeda de la Cerda

E-Mail Website
Guest Editor
Medical Technology Department, Health Sciences Faculty, Universidad de Tarapaca, Arica, Chile
Interests: interventional cardiology; pediatrics; diagnostic reference levels; kerma area product; optimization

Special Issue Information

Dear Colleagues,

The number of fluoroscopy-guided interventional procedures in pediatrics is increasing, especially in interventional cardiology. In recent decades, pediatric cardiac catheterization has gone from being a primarily diagnostic tool to becoming a therapeutic modality that has substantially improved the prognosis of congenital cardiac malformations. However, these procedures may involve high radiation doses to patients. Particular attention must be paid to pediatric patients undergoing these procedures, as children are potentially at greater risk of radiation-induced stochastic effects due to the higher radiation sensitivity levels of their tissues compared to adult patients. Furthermore, they have a longer lifespan, in which long-term effects such as neoplasms can develop.

For all of the above, optimization strategies on radiation safety, including quality assurance programs, characterization in terms of the dose and image quality of X-ray systems, quality control tests of X-ray systems, the measurement of patient doses, the use of dose automation systems, the categorization of procedures,  and the establishment of diagnostic reference levels (DRLs), should be prioritized in pediatrics.

This Special Issue aims to deal with the latest developments in New Optimization Strategies on Radiation Protection in Fluoroscopy-Guided Interventional Procedures in Pediatrics.

We welcome original manuscripts or other types of papers on the establishment of DRLs, quality assurance, basic quality controls, experience with dose automation systems, the categorization of procedures, and occupational dosimetry.

Dr. Carlos Ubeda de la Cerda
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • interventional cardiology
  • pediatrics
  • diagnostic reference levels
  • kerma area product
  • optimization

Published Papers (4 papers)

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Editorial

Jump to: Research, Review, Other

3 pages, 185 KiB  
Editorial
New Optimization Strategies on Radiation Protection in Fluoroscopy-Guided Interventional Procedures in Pediatrics
by Carlos Ubeda
Children 2023, 10(5), 883; https://doi.org/10.3390/children10050883 - 15 May 2023
Cited by 3 | Viewed by 1152
Abstract
The term fluoroscopically guided interventional procedure describes a clinical practice in medicine, where fluoroscopic systems are used to conduct diagnostic procedures or provide image guidance for therapeutic interventional procedures performed via percutaneous or other access routes [...] Full article
(This article belongs to the Special Issue New Optimization Strategies on Radiation Protection in Fluoroscopy-Guided Interventional Procedures in Pediatrics)

Research

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12 pages, 3742 KiB  
Article
An Approach to Establishing Diagnostic Reference Levels in Interventional Pediatric Cardiology from Different Regions of Brazil
by Viviane K. Asfora, Marcelo B. Freitas, Regina B. Medeiros, Hugo R. Schelin, Akemi Yagui, Marcus V. L. Oliveira, Luiz M. S. A. Leite, Guillermo A. Lopez, Maryanna R. S. Roberto, Fabio L. Gagetti, Pablo H. O. Souza, Bruna Vargas, Valeriy V. Denyak and Helen J. Khoury
Children 2024, 11(2), 200; https://doi.org/10.3390/children11020200 - 05 Feb 2024
Viewed by 876
Abstract
Diagnostic reference levels (DRLs) are a pivotal strategy to be implemented since pediatric interventional cardiology procedures are increasing. This work aimed to propose an initial set of Brazilian DRLs for pediatric interventional diagnostic and therapeutic (D&T) procedures. A retrospective study was carried out [...] Read more.
Diagnostic reference levels (DRLs) are a pivotal strategy to be implemented since pediatric interventional cardiology procedures are increasing. This work aimed to propose an initial set of Brazilian DRLs for pediatric interventional diagnostic and therapeutic (D&T) procedures. A retrospective study was carried out in four Brazilian states, distributed across the three regions of the country. Data were collected from pediatric patients undergoing cardiac interventional procedures (CIPs), including their age and anthropometric characteristics, and at least four parameters (number of images, exposure time, air kerma–area product—PKA, and cumulative air kerma). Data from 279 patients undergoing CIPs were gathered (147 diagnostic and 132 therapeutic procedures). There were no significant differences in exposure time and the number of images between the D&T procedures. A wide range of PKA was observed when the therapeutic procedures were compared to diagnostics for all age groups. There were significant differences between the D&T procedures, whether grouping data by patient weight or age. In terms of cumulative air kerma, it was noted that no value exceeded the level to trigger a monitoring process for patients. This study shows that it is possible to adopt them as the first proposal to establish national DRLs considering pediatric patient groups. Full article
(This article belongs to the Special Issue New Optimization Strategies on Radiation Protection in Fluoroscopy-Guided Interventional Procedures in Pediatrics)
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Review

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16 pages, 780 KiB  
Review
Physical Image Quality Metrics for the Characterization of X-ray Systems Used in Fluoroscopy-Guided Pediatric Cardiac Interventional Procedures: A Systematic Review
by Diego Nocetti, Kathia Villalobos and Kevin Wunderle
Children 2023, 10(11), 1784; https://doi.org/10.3390/children10111784 - 05 Nov 2023
Viewed by 1310
Abstract
Pediatric interventional cardiology procedures are essential in diagnosing and treating congenital heart disease in children; however, they raise concerns about potential radiation exposure. Managing radiation doses and assessing image quality in angiographs becomes imperative for safe and effective interventions. This systematic review aims [...] Read more.
Pediatric interventional cardiology procedures are essential in diagnosing and treating congenital heart disease in children; however, they raise concerns about potential radiation exposure. Managing radiation doses and assessing image quality in angiographs becomes imperative for safe and effective interventions. This systematic review aims to comprehensively analyze the current understanding of physical image quality metrics relevant for characterizing X-ray systems used in fluoroscopy-guided pediatric cardiac interventional procedures, considering the main factors reported in the literature that influence this outcome. A search in Scopus and Web of Science, using relevant keywords and inclusion/exclusion criteria, yielded 14 relevant articles published between 2000 and 2022. The physical image quality metrics reported were noise, signal-to-noise ratio, contrast, contrast-to-noise ratio, and high-contrast spatial resolution. Various factors influencing image quality were investigated, such as polymethyl methacrylate thickness (often used to simulate water equivalent tissue thickness), operation mode, anti-scatter grid presence, and tube voltage. Objective evaluations using these metrics ensured impartial assessments for main factors affecting image quality, improving the characterization of fluoroscopic X-ray systems, and aiding informed decision making to safeguard pediatric patients during procedures. Full article
(This article belongs to the Special Issue New Optimization Strategies on Radiation Protection in Fluoroscopy-Guided Interventional Procedures in Pediatrics)
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Other

10 pages, 1028 KiB  
Brief Report
Diagnostic Reference Levels in Interventional Pediatric Cardiology: Two-Year Experience in a Tertiary Referral Hospital in Latin America
by Ana M. Aristizabal, Jaiber A. Gutiérrez, Emmanuel Ramirez, Valentina Mejía-Quiñones, Carlos Ubeda, Walter Fernando Mosquera and Walter Mosquera
Children 2023, 10(10), 1588; https://doi.org/10.3390/children10101588 - 23 Sep 2023
Viewed by 803
Abstract
The goal of the present study was to propose the first local diagnostic reference levels (DRLs) for interventional pediatric cardiology procedures in a large hospital in Colombia. The data collection period was from April 2020 to July 2022. The local DRLs were calculated [...] Read more.
The goal of the present study was to propose the first local diagnostic reference levels (DRLs) for interventional pediatric cardiology procedures in a large hospital in Colombia. The data collection period was from April 2020 to July 2022. The local DRLs were calculated as the 3rd quartile of patient-dose distributions for the kerma-area product (Pka) values. The sample of collected clinical procedures (255) was divided into diagnostic and therapeutic procedures and grouped into five weight and five age bands. The Pka differences found between diagnostic and therapeutic procedures were statistically significant in all weight and age bands, except for the 1–5-year age group. The local DRLs for weight bands were 3.82 Gy·cm2 (<5 kg), 7.39 Gy·cm2 (5–<15 kg), 19.72 Gy·cm2 (15–<30 kg), 28.99 Gy·cm2 (30–<50 kg), and 81.71 Gy·cm2 (50–<80 kg), respectively. For age bands, the DRLs were 3.97 Gy·cm2 (<1 y), 9.94 Gy·cm2 (1–<5 y), 20.82 Gy·cm2 (5–<10 y), 58.00 Gy·cm2 (10–<16 y), and 31.56 Gy·cm2 (<16 y), respectively. In conclusion, when comparing our results with other existing DRL values, we found that they are similar to other centers and thus there is scope to continue optimizing the radiation dose values. This will contribute to establishing national DRLs for Colombia in the near future. Full article
(This article belongs to the Special Issue New Optimization Strategies on Radiation Protection in Fluoroscopy-Guided Interventional Procedures in Pediatrics)
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