{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:12:37Z","timestamp":1789017157286,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T00:00:00Z","timestamp":1695427200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Center for Clinical Investigation of the Fundacion Valle del Lili Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The goal of the present study was to propose the first local diagnostic reference levels (DRLs) for interventional pediatric cardiology procedures in a large hospital in Colombia. The data collection period was from April 2020 to July 2022. The local DRLs were calculated as the 3rd quartile of patient-dose distributions for the kerma-area product (Pka) values. The sample of collected clinical procedures (255) was divided into diagnostic and therapeutic procedures and grouped into five weight and five age bands. The Pka differences found between diagnostic and therapeutic procedures were statistically significant in all weight and age bands, except for the 1\u20135-year age group. The local DRLs for weight bands were 3.82 Gy\u00b7cm2 (&lt;5 kg), 7.39 Gy\u00b7cm2 (5\u2013&lt;15 kg), 19.72 Gy\u00b7cm2 (15\u2013&lt;30 kg), 28.99 Gy\u00b7cm2 (30\u2013&lt;50 kg), and 81.71 Gy\u00b7cm2 (50\u2013&lt;80 kg), respectively. For age bands, the DRLs were 3.97 Gy\u00b7cm2 (&lt;1 y), 9.94 Gy\u00b7cm2 (1\u2013&lt;5 y), 20.82 Gy\u00b7cm2 (5\u2013&lt;10 y), 58.00 Gy\u00b7cm2 (10\u2013&lt;16 y), and 31.56 Gy\u00b7cm2 (&lt;16 y), respectively. In conclusion, when comparing our results with other existing DRL values, we found that they are similar to other centers and thus there is scope to continue optimizing the radiation dose values. This will contribute to establishing national DRLs for Colombia in the near future.<\/jats:p>","DOI":"10.3390\/children10101588","type":"journal-article","created":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T10:40:22Z","timestamp":1695552022000},"page":"1588","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Diagnostic Reference Levels in Interventional Pediatric Cardiology: Two-Year Experience in a Tertiary Referral Hospital in Latin America"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2234-5152","authenticated-orcid":false,"given":"Ana M.","family":"Aristizabal","sequence":"first","affiliation":[{"name":"Servicio de Cardiolog\u00eda Pedi\u00e1trica, Departamento Materno Infantil, Fundaci\u00f3n Valle del Lili, Cra. 98 No. 18\u201349, Cali 760032, Colombia"},{"name":"Facultad de Ciencias de la Salud, Universidad Icesi, Cali 760031, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaiber A.","family":"Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda Pedi\u00e1trica, Departamento Materno Infantil, Fundaci\u00f3n Valle del Lili, Cra. 98 No. 18\u201349, Cali 760032, Colombia"},{"name":"Facultad de Ciencias de la Salud, Universidad Icesi, Cali 760031, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6402-6777","authenticated-orcid":false,"given":"Emmanuel","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Oficina de F\u00edsica M\u00e9dica & Protecci\u00f3n Radiol\u00f3gica, Fundaci\u00f3n Valle del Lili, Cra. 98 No. 18\u201349, Cali 760032, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Mej\u00eda-Qui\u00f1ones","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Universidad Icesi, Cali 760031, Colombia"},{"name":"Centro de Investigaciones Cl\u00ednicas, Fundaci\u00f3n Valle del Lili, Cra. 98 No. 18\u201349, Cali 760032, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2565-5850","authenticated-orcid":false,"given":"Carlos","family":"Ubeda","sequence":"additional","affiliation":[{"name":"Diagn\u00f3stico por Imagen, Laboratorio de Dosimetr\u00eda Personal (LABODOP), Departamento de Tecnolog\u00eda M\u00e9dica, Facultad de Ciencias de la Salud, Universidad de Tarapac\u00e1, Arica 1020000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter Fernando","family":"Mosquera","sequence":"additional","affiliation":[{"name":"Servicio de Hospitalizaci\u00f3n, Fundaci\u00f3n Valle del Lili, Cra. 98 No. 18\u201349, Cali 760032, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Mosquera","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda Pedi\u00e1trica, Departamento Materno Infantil, Fundaci\u00f3n Valle del Lili, Cra. 98 No. 18\u201349, Cali 760032, Colombia"},{"name":"Facultad de Ciencias de la Salud, Universidad Icesi, Cali 760031, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"370","DOI":"10.12688\/f1000research.13021.1","article-title":"Recent advances in cardiac catheterization for congenital heart disease","volume":"7","author":"Kang","year":"2018","journal-title":"F1000Research"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"237","DOI":"10.3345\/kjp.2017.60.8.237","article-title":"Recent advances in pediatric interventional cardiology","volume":"60","author":"Kim","year":"2017","journal-title":"Korean J. Pediatr."},{"key":"ref_3","unstructured":"ICRP (2007). International Commission on Radiological Protection. The recommendations of the international commission on radiological protection. Ann. ICRP, 37, 1\u2013332."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"ICRP (2013). International Commission on Radiological Protection. Radiological protection in paediatric diagnostic and interventional radiology. Ann. ICRP, 42, 1\u201363.","DOI":"10.1016\/j.icrp.2012.10.001"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s00247-006-0192-4","article-title":"Practice of ALARA in the pediatric interventional suite","volume":"36","author":"Connolly","year":"2006","journal-title":"Pediatr. Radiol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Ubeda, C. (2023). New Optimization Strategies on Radiation Protection in Fluoroscopy-Guided Interventional Procedures in Pediatrics. Children, 10.","DOI":"10.3390\/children10050883"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1118\/1.4905116","article-title":"Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values","volume":"42","author":"Ubeda","year":"2015","journal-title":"Med. Phys."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/0146645317717209","article-title":"ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging","volume":"46","author":"Miller","year":"2017","journal-title":"Ann. ICRP"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2424","DOI":"10.1118\/1.3702590","article-title":"Pilot program on patient dosimetry in pediatric interventional cardiology in Chile","volume":"39","author":"Ubeda","year":"2012","journal-title":"Med. Phys."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"ac87b7","DOI":"10.1088\/1361-6498\/ac87b7","article-title":"Setting up regional diagnostic reference levels for pediatric interventional cardiology in Latin America and the Caribbean countries: Preliminary results and identified challenges","volume":"42","author":"Ubeda","year":"2022","journal-title":"J. Radiol. Prot."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1002\/ccd.25467","article-title":"Standardizing radiation dose reporting in the pediatric cardiac catheterization laboratory-a multicenter study by the CCISC (Congenital Cardiovascular Interventional Study Consortium)","volume":"84","author":"Kobayashi","year":"2014","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_12","first-page":"215","article-title":"Optimizaci\u00f3n de la protecci\u00f3n en radiolog\u00eda y cardiolog\u00eda intervencionista pediatrica en Am\u00e9rica Latina y el Caribe (OPRIPALC)","volume":"7","author":"Ubeda","year":"2021","journal-title":"J. Health Med. Sci."},{"key":"ref_13","unstructured":"(2023, April 05). Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean (OPRIPALC). Available online: www.opripalc.org."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"72","DOI":"10.4067\/S0717-95022017000100013","article-title":"Checklist for reporting results using observational descriptive studies as research designs. The MInCir initiative","volume":"35","author":"Manterola","year":"2017","journal-title":"Int. J. Morphol."},{"key":"ref_15","unstructured":"(2023, April 10). Available online: https:\/\/www.pub.iaea.org\/MTCD\/Publications\/PDF\/TE-1958web.pdf."},{"key":"ref_16","unstructured":"ICRU (2005). Patient Dosimetry for X-rays Used in Medical Imaging ICRU Report 74, International Commission on Radiological Units and Measurements."},{"key":"ref_17","unstructured":"(2010). Medical Electrical Equipment\u2014Part 2-43: Particular Requirements for the Basic Safety and Essential Performance of X-ray Equipment for Interventional Procedures 60601-2-43 2nd ed. (Standard No. IEC 60601-2-43:2010)."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"210","DOI":"10.4103\/IJPSYM.IJPSYM_193_19","article-title":"The P Value and Statistical Significance: Misunderstandings, Explanations, Challenges, and Alternatives","volume":"41","author":"Andrade","year":"2019","journal-title":"Indian J. Psychol. Med."},{"key":"ref_19","unstructured":"StataCorp (2019). Stata Statistical Software: Release 16, StataCorp LLC."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"4749","DOI":"10.1088\/0031-9155\/52\/16\/003","article-title":"Patient doses from fluoroscopically guided cardiac procedures in pediatrics","volume":"52","author":"Martinez","year":"2007","journal-title":"Phys. Med. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1002\/ccd.23118","article-title":"Characterization of radiation exposure and effect of a radiation monitoring policy in a large volume pediatric cardiac catheterization lab","volume":"79","author":"Verghese","year":"2012","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1088\/0952-4746\/35\/1\/179","article-title":"Patient doses in paediatric interventional cardiology: Impact of 3D rotational angiography","volume":"35","author":"Corredoira","year":"2015","journal-title":"J. Radiol. Prot."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.ejmp.2018.01.009","article-title":"Towards the definition of Institutional diagnostic reference levels in paediatric interventional cardiology procedures in Greece","volume":"46","author":"Kottou","year":"2018","journal-title":"Phys. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"108539","DOI":"10.1016\/j.radphyschem.2019.108539","article-title":"Patient radiation doses in paediatric interventional cardiology and optimization actions","volume":"168","author":"Ubeda","year":"2020","journal-title":"Radiat. Phys. Chem."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1093\/rpd\/ncad139","article-title":"Pediatric diagnostic reference levels for diagnostic and therapeutic cardiac catheterization in Japan","volume":"199","author":"Ishibashi","year":"2023","journal-title":"Radiat. Prot. Dosim."},{"key":"ref_26","unstructured":"IAEA (2018). Radiation Protection and Safety in Medical Uses of Ionizing Radiation."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.radi.2013.04.006","article-title":"The establishment of local diagnostic reference levels for paediatric interventional cardiology","volume":"19","author":"McFadden","year":"2013","journal-title":"Radiography"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1007\/s00246-014-0895-5","article-title":"Local reference levels and organ doses from paediatric cardiac interventional procedures","volume":"35","author":"Barnaoui","year":"2014","journal-title":"Pediatr. Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Buytaert, D., Vandekerckhove, K., Panzer, J., Rubbens, L., De Wolf, D., and Bacher, K. (2019). Local DRLs and automated risk estimation in paediatric interventional cardiology. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0220359"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1093\/rpd\/ncab072","article-title":"Dose evaluation and proposal of local diagnostic reference levels for paediatric cardiac catheterizations performed on a high-sensitivity angiographic system allowing low-dose imaging","volume":"195","author":"Hultenmo","year":"2021","journal-title":"Radiat. Prot. Dosim."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"ICRP (2000). Avoidance of radiation injuries from medical interventional procedures. Ann. ICRP, 30, 7\u201367.","DOI":"10.1016\/S0146-6453(01)00004-5"},{"key":"ref_32","unstructured":"(2023, August 02). Steps for Radiation Safety in Pediatric Interventional Radiology. Available online: http:\/\/www.imagegently.org\/Portals\/6\/Procedures\/Steps%20for%20Radiation%20Safety%20in%20Pediatric%20Interventional%20Radiology.pdf?ver=FBueW4YF1I7F_V8nDrinbA%3d%3d."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1161\/CIRCULATIONAHA.109.904458","article-title":"Radiation risk from pediatric cardiac catheterization: Friendly fire on children with congenital heart disease","volume":"120","author":"Andreassi","year":"2009","journal-title":"Circulation"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1259\/bjr\/21696839","article-title":"Impact of biplane versus single-plane imaging on radiation dose, contrast load and procedural time in coronary angioplasty","volume":"83","author":"Sadick","year":"2010","journal-title":"Br. J. Radiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s00246-018-2024-3","article-title":"Congenital Cardiac Catheterization Project on Outcomes-Quality Improvement (C3PO-QI). Radiation Risk Categories in Cardiac Catheterization for Congenital Heart Disease: A Tool to Aid in the Evaluation of Radiation Outcomes","volume":"40","author":"Quinn","year":"2019","journal-title":"Pediatric. Cardiol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/10\/1588\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:56:37Z","timestamp":1760129797000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/10\/1588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,23]]},"references-count":35,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["children10101588"],"URL":"https:\/\/doi.org\/10.3390\/children10101588","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,23]]}}}