RADIATION EXPOSURE AND EFFICACY OF EXPOSURE-REDUCTION TECHNIQUES DURING CARDIAC-CATHETERIZATION IN CHILDREN

OBJECTIVE. The purpose of this study was to measure radiation exposure levels in children undergoing cardiac catheterization. This informati on was used to assess methods of reducing exposure and to characterize total exposures. SUBJECTS AND METHODS. The radiation exposure area pr oduct was determined for a total of 175 patients during three study in tervals over 10 years. Examinations included biplane fluoroscopy and c ineangiography for the diagnosis and treatment of congenital heart dis ease. RESULTS. The use of pulsed progressive fluoroscopy was found to reduce patients' fluoroscopic exposure rates by approximately 40% as c ompared with interlaced mode fluoroscopy. Combining exposures from the frontal and lateral projections, the median fluoroscopic time for dia gnostic procedures was 21 min and the median time for cineangiography was 42 sec. Median total exposure area product was 2063 R-cm(2) with c ineangiography accounting for 44% of the total exposure. For an estima ted X-ray beam entrance area of 50-100 cm(2), the median total entranc e exposure was in the range of 20-40 R. Fluoroscopy times for interven tional procedures were found to be 1.5 to 2.5 times longer than for di agnostic procedures, with total exposures approximately three times hi gher. CONCLUSION. This study suggests that pulsed progressive fluorosc opy is an effective method of reducing radiation exposure in children undergoing cardiac catheterization.