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JOURNAL
MURTAZA KAMAL
18/04/2018
Projected future cancer risks in children
treated with fluoroscopy guided cardiac cats
procedures
Circulation: Cardiovascular interventions;
2018, Nov
Introduction
• Kids treated with cath—> Now a long life expectancy—>
Potential for long term radiation induced risks
• Gy/ Sv: 1J/ kg
• Normally: 3-15mSv
• Kids: Sensitive
• Radiation related cancers: Long latency times
Aim of study
• To report projected lifetime excess CA risk in kids
undergoing ASD, PDA closure, pulmonary valvuloplasty
Study population
• All kids less than 15 y
• ASD/ PDA closure/ pul valvuloplasty
• 2009-2013
• 2 centers in France
• Excluded: Without mandatory data
Methods+ results
• 1175 kids/ 1251 procedures
• Organ equivalent dosage calculated
• Median LAR per 1000 procedures:
• ASD: 0.3-1.4
• PDA: 0.6-5
• PBPV: 1-12
Results…
• 0.4-6% of children’s total lifetime cancer risk
• For 10% procedures with highest exposures (all types combined):
• Boys: LAR 4.2/ 1000
• Girls: LAR 22.2/ 1000
• Cancer types:
• Boys: Lung CA- 70-80% of projected LAR
• Girls: Lung CA- 20-60%; Breast CA: 30-80% excess risk
Conclusions…
• Radiation exposure—> Substancial radiation dosage—>
Increased CA risks
• Need for dose reporting to support recommendations for
long term surveillance+ prevention strategies when
needed
Thanks…

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CANCER RISK IN CARDIAC CATHETERIZATION

  • 2. Projected future cancer risks in children treated with fluoroscopy guided cardiac cats procedures Circulation: Cardiovascular interventions; 2018, Nov
  • 3. Introduction • Kids treated with cath—> Now a long life expectancy—> Potential for long term radiation induced risks • Gy/ Sv: 1J/ kg • Normally: 3-15mSv • Kids: Sensitive • Radiation related cancers: Long latency times
  • 4. Aim of study • To report projected lifetime excess CA risk in kids undergoing ASD, PDA closure, pulmonary valvuloplasty
  • 5. Study population • All kids less than 15 y • ASD/ PDA closure/ pul valvuloplasty • 2009-2013 • 2 centers in France • Excluded: Without mandatory data
  • 6. Methods+ results • 1175 kids/ 1251 procedures • Organ equivalent dosage calculated • Median LAR per 1000 procedures: • ASD: 0.3-1.4 • PDA: 0.6-5 • PBPV: 1-12
  • 7. Results… • 0.4-6% of children’s total lifetime cancer risk • For 10% procedures with highest exposures (all types combined): • Boys: LAR 4.2/ 1000 • Girls: LAR 22.2/ 1000 • Cancer types: • Boys: Lung CA- 70-80% of projected LAR • Girls: Lung CA- 20-60%; Breast CA: 30-80% excess risk
  • 8. Conclusions… • Radiation exposure—> Substancial radiation dosage—> Increased CA risks • Need for dose reporting to support recommendations for long term surveillance+ prevention strategies when needed