Protocol for reducing radiation exposure during pediatric thoracic radiography

Carla Daruich De Souza; Gustavo Rico Freitas; Rogério Fachel Medeiros; Ercilia Ramalho; Sergio Chaves Rodrigues; Guilherme Oberto Rodrigues

doi:10.1016/j.jmir.2022.05.012

Protocol for reducing radiation exposure during pediatric thoracic radiography

J Med Imaging Radiat Sci. 2022 Sep;53(3):437-443. doi: 10.1016/j.jmir.2022.05.012. Epub 2022 Jun 21.

Authors

Carla Daruich De Souza¹, Gustavo Rico Freitas², Rogério Fachel Medeiros³, Ercilia Ramalho⁴, Sergio Chaves Rodrigues⁵, Guilherme Oberto Rodrigues⁶

Affiliations

¹ Laboratory for Radiation Therapy Sources Production, Nuclear and Energy Research Institute, Prof. Lineu Prestes Avenue, 2242 - Butantã, São Paulo, SP 05508-000, Brazil. Electronic address: cdsouza@ipen.br.
² Laboratory for Radiation Therapy Sources Production, Nuclear and Energy Research Institute, Prof. Lineu Prestes Avenue, 2242 - Butantã, São Paulo, SP 05508-000, Brazil; Regional Hospital of Cotia, Dr. Odair Pacheco Pedroso Avenue, 171 - Jardim Monte Santo, Cotia, SP 06717-200, Brazil.
³ Federal University of Rio Grande do Sul, Paulo Gama Avenue, 110 - Farroupilha, Rio Grande do Sul 90040-060, Brazil.
⁴ Finaci College, São Joaquim Street, 352 - Liberdade, São Paulo, SP 01508-901, Brazil.
⁵ Federal University of Health Care Sciences of Porto Alegre, Sarmento Leite Street, 245 - Centro Histórico, Porto Alegre, RS 90050-170, Brazil.
⁶ Federal University of Health Care Sciences of Porto Alegre, Sarmento Leite Street, 245 - Centro Histórico, Porto Alegre, RS 90050-170, Brazil; Institute of Cardiology, University Foundation of Cardiology of Rio Grande do Sul, Princesa Isabel Avenue, 395 - Santana, Porto Alegre, RS 90040-371, Brazil; São Camilo University, Nazaré Avenue, 1501 - Ipiranga, São Paulo, SP 04263-200, Brazil.

PMID: 35750602
DOI: 10.1016/j.jmir.2022.05.012

Abstract

Introduction: This work aims to assess if the anode position during chest radiography of pediatric patients with heart congenital disease (HCD) influences medical image results. The approach is to reverse the orientation of the x-ray tube, with the anode end directed towards the patient's face (anode-heel effect).

Methods: Five specialists analyzed 48 images, 24 from the control group (CG) and 24 with the anode end directed towards the patients' face (experimental group, EC). An ionization chamber was used to assess radiation dose received by sensitive organs.

Results: The specialists considered both CG and EC images acceptable. But, the EC group's dose evaluation revealed that the thyroid received 12% less radiation and the gonads presented a 5.9% reduction. Based on the results, a new protocol was developed.

Discussion/conclusion: The standardization of radiographic imaging procedures will reduce acquisition errors, resulting in adequate images in pediatric patients with HCD with less radiation dose, thus increasing patient safety and extending the life of the equipment.

Trial registration: ClinicalTrials.gov NCT02925936.

Keywords: Anode-heel effect; Congenital disease; Diagnostic imaging; Heart; Radiation diagnosis; Radiography; Thoracic radiography; X-ray in children.

MeSH terms

Child
Gonads
Humans
Radiation Dosage
Radiation Exposure*
Radiography
Radiography, Thoracic*

Associated data

ClinicalTrials.gov/NCT02925936