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The pilot dose survey on paediatric general radiography, fluoroscopy and CT procedures was performed in four university hospitals. The analysis of data was focused on the radiography and CT imaging of head, chest, abdomen, pelvis and spine and fluoroscopic procedures of gastrointestinal and urinary tracts. The survey was conducted by the National Radiation Protection Institute. Two hospitals exported data from the patient dose management system, while the others collected the data manually. The methodology of diagnostic reference levels assessment was proposed and tested. Local diagnostic reference levels were calculated in terms of air kerma-area product $P_{KA}$, CT air kerma-length product $P_{KL,CT}$ and volumetric CT air kerma index $C_{VOL}$. The lack of procedure standardisation, e.g. in tube voltage setting irrespective of patient's weight, was revealed at one hospital. Dose and exposure parameters distributions with respect to patient's anatomical constitution are presented in this article. In future, this pilot study will be a base for national survey of paediatric diagnostic reference levels.

MeSH
dávka záření MeSH
dítě MeSH
fluoroskopie metody MeSH
gastrointestinální nemoci diagnostické zobrazování MeSH
intervenční radiografie metody MeSH
kritické orgány účinky záření MeSH
lidé MeSH
pilotní projekty MeSH
počítačová rentgenová tomografie metody MeSH
počítačové zpracování obrazu metody MeSH
radiační expozice analýza MeSH
radiační ochrana MeSH
urologické nemoci diagnostické zobrazování MeSH
Check Tag
dítě MeSH
lidé MeSH
Publikační typ
časopisecké články MeSH
Geografické názvy
Česká republika MeSH

Článek online

The impact of ECG synchronization during acquisition of left-atrium computed tomography model on radiation dose and arrhythmia recurrence rate after catheter ablation of atrial fibrillation - a prospective, randomized study

Bratislavské lekárske listy. 2019 ; 120 (3) : 177-183.

ISSN 0006-9248
Medvik
Zdroj

BACKGROUND: The impact of ECG gating during computed tomography (CT) acquisition of left atrium (LA) model on radiation dose, image quality and ablation event-free survival rate after catheter ablation (CA) of atrial fi brillation (AF) is not well defi ned. METHODS: Sixty-two patients with paroxysmal atrial fi brillation were randomized for two types of LA CT (with vs without ECG gating) before CA. Pulmonary veins isolation was performed in all patients. Patients were followed for 12 months after CA. RESULTS: There was no difference between the groups in CA length (131.61±32.57 vs 119.84±33.18 min; p=0.108), CA fl uoroscopy time (4.48±2.19 vs 3.89±1.83 min; p=0.251), CA fl uoroscopy dose (3.99±2.79 vs 3.91 vs2.91 Gy*cm2; p=0.735), visual data quality (1.77±0.88 vs 2.0±0.63; p=0.102) and registration error (2.42±0.72 vs 2.43±0.46 mm; p=0.612). We found a significant difference in CT Dose index (89.55±5.99 vs 19.19±4.33 mGy; p<0.0001) and Dose Length product (1438.87±147.75 vs 328.21±73.83 mGy*cm; p<0.0001). Twelve months after CA, 25 of 31 patients in the gated group and 24 of 31 patients in the non-gated group were free of AF (80.65 vs 77.42 %; p=0.838). CONCLUSION: ECG gating of computed tomography of LA before AF ablation burdens patients with a four times higher radiation dose while improving neither the quality of CT model or fusion of CT with the electroana-tomic map. As a result, it has no significant impact on arrhythmia recurrence rate after ablation (Tab. 3, Fig. 3, Ref. 25).