{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:57:10Z","timestamp":1792717030089,"version":"4.5.0"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,6,17]],"date-time":"2016-06-17T00:00:00Z","timestamp":1466121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01 HL10971"],"award-info":[{"award-number":["R01 HL10971"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To quantify the impact of image optimization on absorbed radiation dose and associated risk in children undergoing cardiac catheterization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Various imaging and fluoroscopy system technical parameters including camera magnification, source\u2010to\u2010image distance, collimation, antiscatter grids, beam quality, and pulse rates, all affect radiation dose but have not been well studied in younger children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used anthropomorphic phantoms (ages: newborn and 5 years old) to measure surface radiation exposure from various imaging approaches and estimated absorbed organ doses and effective doses (ED) using Monte Carlo simulations. Models developed in the National Academies' Biological Effects of Ionizing Radiation VII report were used to compare an imaging protocol optimized for dose reduction versus suboptimal imaging (+20 cm source\u2010to\u2010image\u2010distance, +1 magnification setting, no collimation) on lifetime attributable risk (LAR) of cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For the newborn and 5\u2010year\u2010old phantoms, respectively ED changes were as follows: +157% and +232% for an increase from 6\u2010inch to 10\u2010inch camera magnification; +61% and +59% for a 20 cm increase in source\u2010to\u2010image\u2010distance; \u221242% and \u221248% with addition of 1\u2010inch periphery collimation; \u221231% and \u221246% with removal of the antiscatter grid. Compared with an optimized protocol, suboptimal imaging increased ED by 2.75\u2010fold (newborn) and fourfold (5 years old). Estimated cancer LAR from 30\u2010min of posteroanterior fluoroscopy using optimized versus suboptimal imaging, respectively was 0.42% versus 1.23% (newborn female), 0.20% versus 0.53% (newborn male), 0.47% versus 1.70% (5\u2010year\u2010old female) and 0.16% versus 0.69% (5\u2010year\u2010old male).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Radiation\u2010related risks to children undergoing cardiac catheterization can be substantial but are markedly reduced with an optimized imaging approach. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.26630","type":"journal-article","created":{"date-parts":[[2016,6,17]],"date-time":"2016-06-17T13:42:58Z","timestamp":1466170978000},"page":"888-897","source":"Crossref","is-referenced-by-count":12,"title":["Impact of imaging approach on radiation dose and associated cancer risk in children undergoing cardiac catheterization"],"prefix":"10.1002","volume":"89","author":[{"given":"Kevin D.","family":"Hill","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology Duke University Medical Center Durham North Carolina"},{"name":"Department of Medicine, Division of Cardiology Duke Clinical Research Institute Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology Duke University Medical Center Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Einstein","sequence":"additional","affiliation":[{"name":"Department of Radiology Columbia University Medical Center and New York\u2010Presbyterian Hospital New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Januzis","sequence":"additional","affiliation":[{"name":"Department of Radiology Duke University Medical Center Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giao","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Radiology Duke University Medical Center Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology Duke University Medical Center Durham North Carolina"},{"name":"Department of Medicine, Division of Cardiology Duke Clinical Research Institute Durham North Carolina"},{"name":"Department of Radiology Duke University Medical Center Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A.","family":"Fleming","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology Duke University Medical Center Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry K.","family":"Yoshizumi","sequence":"additional","affiliation":[{"name":"Department of Radiology Duke University Medical Center Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,17]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.icrp.2007.11.001"},{"key":"e_1_2_5_3_1","volume-title":"Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2","author":"Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation; Nuclear and Radiation Studies Board, Division on Earth and Life Studies, National Research Council of the National Academies.","year":"2006"},{"key":"e_1_2_5_4_1","volume-title":"Effects of Ionizing Radiation","author":"UNSCEAR.","year":"2006"},{"key":"e_1_2_5_5_1","volume-title":"Ionizing Radiation Exposure of the Population of the United States (NCRP Report No 160)","author":"National Council on Radiation Protection and Measurements.","year":"2009"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f2360"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60815-0"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005425"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.6122"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-006-0194-2"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2252011414"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(07)61274-3"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.04.013"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2009.04.037"},{"key":"e_1_2_5_15_1","unstructured":"TapiovaaraM SiiskonenT. 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