Patient radiation exposure during pediatric cardiac catheterization

Exposure area product (EAP) and center field entrance exposure (free-in-air) were measured in seventeen pediatric patients undergoing cardiac catheterization. Exposures were recorded separately for biplane fluoroscopy and cine angiocardiography using flat-plate ionization chambers. In the posterior-anterior (PA) projections, median EAP was 425 Roentgen-square centimeter (R-cm2), with a range of 90.5-3,882 R-cm2;29-35% of this exposure occurred during cine filming. In the lateral projection, median EAP was 276 R-cm2 (range 117-1,173); 52-59% of this exposure was due to cine filming. Median center field entrance exposure in the PA view was 7.86 Roentgens (R) with a range 2.16-73.9 of and in the lateral projection 7.39 R (range 2.64-24.6). As much as 25% of the exposure from the entire examination was contributed by manual "test" exposures to set cine radiographic kVp. We recommend use of testing circuits, which determine cine radiographic factors automatically and thus should lower levels of exposure.