Radiation Reduction in Paediatric Cardiac Catheterization: We Can Go Even Lower
Bibliographic record
Abstract
BackgroundRadiation reduction is an integral component in the management of a pediatric cardiac catheterization laboratory. Simple and easily implementable protocol changes and technical upgrades have been shown to significantly reduce radiation exposure.MethodsRadiation exposures (2020-2022) at Safra Children's Hospital, Sheba Medical Center, Israel (Unit A: n=672) were retrospectively reviewed, including DAP (μGy·m2), DAP/kg, Air Kerma (mGy) and fluoroscopy time (minutes) for 16 procedural types. Median doses were compared with those measured (2011-2014) at the Hospital for Sick Children, Toronto, Canada (Unit B: n=2033). Radiation reduction techniques included fluoroscopy acquisition at 7.5 frames/second, removal of anti-scatter grids for children <30 kg, limiting field of view, use of Philips ClarityIQ technology and an institutional culture of radiation mindedness.ResultsExposure was significantly lower in Unit A in 14 of 16 procedure types. Total median doses were lower in Unit A (DAP 91.4(44.7-205.4) vs. 387(138.2-1339) μGy·m2, (p<0.001), DAP/kg 9.33(4.3-16.4) vs. 29.22(12.8-65.9) μGy·m2/kg, (p<0.001), Air Kerma 14.9(7.8-29) vs. 61(23-176.4) mGy, (p<0.001)) despite higher fluoroscopy time (14.1(4.2-24.6) vs. 12.3(6.8-23.3) minutes, (p=0.03)). DAP was lower for specific procedures including pulmonary valvuloplasty 46.3(14.3-219.3) vs. 127(60-323) μGy·m2, (p<0.001) and PDA closure 51.9(18.8-111.8) vs. 178(96-410) μGy·m2, (p<0.001).ConclusionsEnhanced radiation reduction techniques can lead to lower than previously published exposure levels across a wide range of procedure types when employing dose-limiting protocols and radiation-reduction technology.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".