Roberto Miraglia MD, Abstract Co-Author: Nothing to Disclose

Luigi Maruzzelli MD, Presenter: Nothing to Disclose

Roberta Gerasia, Abstract Co-Author: Nothing to Disclose

Simona Maggio, Abstract Co-Author: Nothing to Disclose

Angelo Luca MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was a comparison between the radiation exposure levels recorded during CVC placement in pediatric patients weighing less than 10 kg, in procedures performed using an image intensifier-based angiographic system (IIDS) and those performed in a flat panel detector-based interventional suite (FPDS).  

A retrospective review of 96 image-guided CVC placements, between January 2008 and October 2013, in 49 pediatric patients weighing less than 10 kg was performed. Mean age was 8.2±4.4 months (range 1 - 22 months). Mean weight was 7.1±2.7 kg (range 2.5 – 9.8 kg). The procedures were classified into 2 categories: non-tunneled and tunneled CVC placement.  

Thirty-five procedures were performed with the IIDS (21 non-tunneled CVC, 14 tunneled CVC); 61 procedures were performed with the FPDS (47 non-tunneled CVC, 14 tunneled CVC). For non-tunneled CVC mean DAP was 113.5±126.7 cGy·cm² with the IIDS and 15.9±44.6 cGy·cm² with the FPDS (p< 0.001). For tunneled CVC mean DAP was 84.6±81.2 cGy·cm² with the IIDS and 37.1±33.5 cGy·cm² with the FPDS (p=0.02). The statistically significant differences of DAP between the two angiographic systems adjusted for the effect of the fluoroscopy time was confirmed by using a multiple generalized linear regression model. In all procedures image quality was considered adequate by a different interventional radiologist other than the operator with no trade-off between satisfactory image quality and procedural outcome. Technical success was obtained in all procedures without major complications.  

The use of flat panel angiographic equipment reduces radiation exposure in small children undergoing image-guided CVC placement.  

Our data suggests that the use of flat panel angiographic equipment reduces radiation exposure in small children undergoing image-guided CVC placement and should be considered first line for pediatric interventional radiology procedures. The systematic recording of DAP and fluoroscopy time at the end of every procedure is also an essential step in determining local and/or general radiation exposure reference levels in this particular group of patients.

Miraglia, R, Maruzzelli, L, Gerasia, R, Maggio, S, Luca, A, Comparison between Radiation Exposures Levels Using an Image Intensifier and A Flat Panel Detector-based System in Image-guided Central Venous Catheter Placement in Pediatric Patients Weighing Less than 10 kg.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002404.html