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

Gould, Richard, McFadden, S. L., Sands, Andrew, McCrossan, Brian, Horn, Simon, Prise, Kevin, Doyle, Philip and Hughes, Ciara (2017) Removal of scatter radiation in paediatric cardiac catheterisation: a randomised controlled clinical trial. Journal of Radiological Protection, 1 . pp. 1-7. [Journal article]

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URL: http://iopscience.iop.org/article/10.1088/1361-6498/aa80a4

Abstract

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 γH2AX 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 γH2AX assay may be used for assessment of dose optimisation strategies in children.

Item Type:Journal article
Keywords:radiation dose, interventional cardiology, radiology, scatter reduction, children
Faculties and Schools:Faculty of Life and Health Sciences
Faculty of Life and Health Sciences > School of Health Sciences
Research Institutes and Groups:Institute of Nursing and Health Research > Centre for Health and Rehabilitation Technologies
Institute of Nursing and Health Research
ID Code:38375
Deposited By: Dr Sonyia McFadden
Deposited On:07 Aug 2017 12:59
Last Modified:19 Jul 2018 22:23

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