Comparison between radiation exposure levels using an image intensifier and a flat-panel detector-based system in image-guided central venous catheter placement in children weighing less than 10 kg

Roberto Miraglia, Luigi Maruzzelli, Kelvin Cortis, Marcello Piazza, Roberta Gerasia, Simona Maggio, Fabio Tuzzolino, Angelo Luca

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Ultrasound-guided central venous puncture and fluoroscopic guidance during central venous catheter (CVC) positioning optimizes technical success and lowers the complication rates in children, and is therefore considered standard practice. Objective: The purpose of this study was to compare the radiation exposure levels recorded during CVC placement in children weighing less than 10 kg in procedures performed using an image intensifier-based angiographic system (IIDS) to those performed in a flat-panel detector-based interventional suite (FPDS). Materials and methods: A retrospective review of 96 image-guided CVC placements, between January 2008 and October 2013, in 49 children 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 two categories: non-tunneled and tunneled CVC placement. Results: 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). Conclusion: The use of flat-panel angiographic equipment reduces radiation exposure in small children undergoing image-guided CVC placement.

Original languageEnglish
Pages (from-to)235-240
Number of pages6
JournalPediatric Radiology
Volume45
Issue number2
DOIs
Publication statusPublished - 2014

Keywords

  • Children
  • Fluoroscopy
  • Interventional radiology
  • Radioprotection

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pediatrics, Perinatology, and Child Health

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