Age-specific and gender-specific radiation risks in paediatric angiography and interventional cardiology: conversion coefficients and risk reference values.

OBJECTIVES

To estimate risk for exposure-induced cancer death (REID), organ-specific risks of exposure-induced cancer death (REID) and associated conversion coefficients (CC=REID/kerma-area product (KAP), CC=REID/KAP) in paediatric cardiac catheterizations using data from radiation dose structured reports (RDSR). A novel risk surveillance tool consisting of age-specific and gender-specific risk reference values (RRVs) related to population cancer risk is suggested.

METHODS

The PCXMC v.2.0 code is used together with exposure-related information from RDSR from a cohort of 238 children to assess cancer risks and related conversion coefficients. The KAP corresponding to 1 in 1000 of increased REID is used to define age-specific and gender-specific KAP values to monitor risk in such patient cohorts, here denoted as RRVs.

RESULTS

The REID estimates ranged from below 1 up to 300 in 100,000, and the RRVs for the different age groups and gender ranged from 0.77 Gycm and 2.1 Gycm for neonates (female, male) to 11 Gycm and 25 Gycm for 15-year-olds (female, male). The CC and CC decreased biexponentially with increased age, being notably higher for female patients.

CONCLUSIONS

Prominent risk contributing organs were the lungs and the (female) breast. The concept of age-specific and gender-specific RRVs related to population cancer risk is introduced and is intended to be used as a supporting tool for physicians performing such interventions.

ADVANCES IN KNOWLEDGE

Age-related and gender-related conversion coefficients for radiation risk, CC and CC, are introduced and a novel risk surveillance concept, the RRV, is suggested for paediatric cardiac catheterizations.