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Radiol. Prot."],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Paediatric patients with congenital heart disease often undergo cardiac catheterisation procedures and are exposed to considerable ionising radiation early in life. This study aimed to develop a method for estimating the dose area product (<jats:italic>P<\/jats:italic>\n                  <jats:sub>KA<\/jats:sub>) from paediatric cardiac catheterisation procedures (1975\u20131989) at a national centre for paediatric cardiology and to evaluate trends in <jats:italic>P<\/jats:italic>\n                  <jats:sub>KA<\/jats:sub> and exposure parameters until 2021. Data from 2200 catheterisation procedures on 1685 patients (1975\u20131989) and 4184 procedures on 2139 patients (2000\u20132021) under 18 years of age were retrospectively collected. <jats:italic>P<\/jats:italic>\n                  <jats:sub>KA<\/jats:sub> values were missing for 1975\u20131989 but available from 2000 onward. The missing <jats:italic>P<\/jats:italic>\n                  <jats:sub>KA<\/jats:sub> was estimated from air kerma and beam area, based on exposure records and input from clinicians working at that time. <jats:italic>P<\/jats:italic>\n                  <jats:sub>KA<\/jats:sub> trends were analysed over time and age. There was a 71% reduction in median <jats:italic>P<\/jats:italic>\n                  <jats:sub>KA<\/jats:sub> from the period 1975\u20131989 (median 6.63 Gy cm<jats:sup>2<\/jats:sup>) to 2011\u20132021 (1.91 Gy cm<jats:sup>2<\/jats:sup>). The <jats:italic>P<\/jats:italic>\n                  <jats:sub>KA<\/jats:sub> increases significantly (<jats:italic>p<\/jats:italic> = 0.0001) with patient age, which was associated with body weight. Approximately 80% of the total <jats:italic>P<\/jats:italic>\n                  <jats:sub>KA<\/jats:sub> was from cine acquisition in 1975\u20131989, while 20% was from fluoroscopy. The <jats:italic>P<\/jats:italic>\n                  <jats:sub>KA<\/jats:sub> estimate during 1975\u20131989 was considerably impacted by the assumptions of missing parameters such as tube filtration, focus-to-heart distance, beam area, and number of cine series. The decreasing trend in <jats:italic>P<\/jats:italic>\n                  <jats:sub>KA<\/jats:sub> values was attributed to advancements in both technologies and clinical practices. The high contribution of cine acquisition to the total dose during 1975\u20131989 was due to factors such as a high frame rate, multiple acquisitions, and high tube current. The estimated <jats:italic>P<\/jats:italic>\n                  <jats:sub>KA<\/jats:sub> values for the period 1975\u20131989 are of importance for the dose reconstruction and risk assessments in the EU epidemiology project Health Effects of Cardiac Fluoroscopy and Modern Radiotherapy in Pediatrics(HARMONIC).<\/jats:p>","DOI":"10.1088\/1361-6498\/ad958e","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T22:48:29Z","timestamp":1732229309000},"page":"041513","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Doses from ionising radiation in paediatric cardiac catheterisations in Norway 1975\u20132021"],"prefix":"10.1088","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6685-6608","authenticated-orcid":true,"given":"S","family":"Afroz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B H","family":"\u00d8ster\u00e5s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thevethas","family":"U S","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Meo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7379-5145","authenticated-orcid":true,"given":"A","family":"Jahnen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9462-5807","authenticated-orcid":true,"given":"J","family":"Dabin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Thierry-Chef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T E","family":"Robsahm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"D\u00f8hlen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H M","family":"Olerud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2024,12,2]]},"reference":[{"key":"jrpad958ebib1","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1136\/hrt.2008.160309","article-title":"Cumulative patient effective dose and acute radiation-induced chromosomal DNA damage in children with congenital heart disease","volume":"96","author":"Ait-Ali","year":"2010","journal-title":"Heart"},{"key":"jrpad958ebib2","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1161\/CIRCULATIONAHA.115.019137","article-title":"Exposure to low-dose ionizing radiation from cardiac procedures in patients with congenital heart disease","volume":"133","author":"Beaus\u00e9jour Ladouceur","year":"2016","journal-title":"Circulation"},{"key":"jrpad958ebib3","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1016\/j.jpeds.2013.10.074","article-title":"Cumulative exposure to medical radiation for children requiring surgery for congenital heart disease","volume":"164","author":"Glatz","year":"2014","journal-title":"J. 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