Evaluation of the kerma-area product and the cumulative air kerma in pediatric interventional cardiology in an exclusively pediatric hospital

Abstract

Interventional cardiology is a favored approach for managing congenital heart diseases in pediatric patients due to its minimally invasive nature. However, the associated radiation exposure raises concerns, especially for younger patients who are more sensitive to ionizing radiation and have higher long-term cancer risks. This study evaluates radiation doses—kerma-area product (P_KA) and cumulative air kerma (K_a,r)— an exclusively pediatric hospital in Brazil, stratifying data by age and weight groups. Data collected from 2019 to 2023 revealed significant variability in dose values compared to international benchmarks. The doses of 215 pediatric interventional cardiology procedures, both diagnostic and therapeutic, performed between 2019 and 2024, were evaluated. The median P_KA values for the procedures, based on the age groups assessed, were as follows: <1 year: 1.6 Gy cm², 1–5 years: 1.3 Gy cm², 5–10 years: 1.0 Gy cm², 10–15 years: 0.8 Gy cm², and >15 years: 8.51 Gy cm². For the weight ranges evaluated, the median P_KA values were: <5 kg: 0.5 Gy cm², 5–15 kg: 1.3 Gy cm², 15–30 kg: 1.11 Gy cm², 30–50 kg: 1.04 Gy cm², and 50–80 kg: 6.4 Gy cm².The results indicate the use of conservative protocols, achieving lower dose values than those reported in recent studies. Although the sample size was limited, the findings emphasize the importance of establishing local diagnostic reference levels (DRLs). Future dose optimization measures, including protocol adjustments and removing anti-scatter grids, are recommended.