Background Pediatric patients undergoing complex interventional procedures can be exposed to extended fluoroscopy time and multiple DSA acquisitions. Since these patient’s have higher cell division they are more susceptible to the negative impact of ionizing radiation induced cell mutation. The aim of this study was to minimize the radiation burden from DSA without loss of diagnostic quality.
Methods and Materials Pediatric patients have lower cranial bone density as well as smaller head circumference size allowing creation of dedicated programs tailored to different age groups. First, a pediatric specific phantom for patients aged five and lower was developed using aluminum (1 cm thickness) and PMMA (20 cm thickness) to simulate bone and brain tissue. Vascular anatomy was simulated using patient specific aneurysm model with one inflow and two outflow ports. The dose was varied from 0.36 µGy/Fr to 1.2 µGy/Fr on a clinical C-Arm system using uniform frame rate. Spatial resolution was assessed using a bar pattern embedded in the PMMA and image quality via visual inspection of the aneurysm flow model. Clinical datasets were acquired alternating low and standard dose settings in progression observation of endovascular treatment.
Findings Spatial resolution in bar pattern did not change with varying dose. Lower dose DSA images have increased noise resulting in a small blurring effect after vendor post-processing however visual image impression in low dose images was accepted as diagnostic.. Post-intervention dose report review showed a dose reduction of 75% in dose per frame compared to the standard of care prior to study conduction.
Conclusion Pediatric patient specific DSA acquisition protocols have been developed lowering the dose to the patients by 75% without loss of diagnostic quality.
Disclosures M. Corriveau: None. Y. Li: None. S. Schafer: None. A. Ahmed: None. D. Niemann: None. B. Aagaard ?Kienitz: None.
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