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Objectives: There is an increasing use of three-dimensional rotational angiography (3D-RA) during catheterization of congenital heart disease. Dose-area-product (DAP) measured by the angiography system and computed-tomography dose index (CTDI) do not appear practical for dose assessment. Hence, we performed real dose measurements in anthropomorphic phantoms. Methods: Three different anthropomorphic phantoms (10 kg, 19 kg and 73 kg bodyweight) equipped with thermoluminescent dosimeters (TLD) were used. We used a typical standard diagnostic program and a low-dose program. The effective dose (ED) was calculated according to the International Commission on Radiological Protection (ICRP) 103. The 3D distribution of radiation in the body was assessed. Results: ED for the male 10 kg phantom was 0.192 mSv in the diagnostic program and 0.050 mSv (male) in the low-dose program. The 19 kg phantom received an ED of 0.205 mSv (male) in the diagnostic program. In the low-dose program the ED reached 0.058 mSv (male). The male adult 73 kg phantom was exposed with an ED of 0.730 mSv in the diagnostic program and 0.282 mSv in the low-dose program. ED for the female phantoms was slightly higher for both acquisition-programs. Dose distribution was inhomogeneous with a dose maximum in the esophageal region behind the heart, whereas in the brain, intestine and gonads we found nearly no radiation. Conclusions: 3D-RA imaging in the interventional catheter laboratory is possible with an effective dose lower than 1 mSv. With its potential to reduce fluoroscopic time and the number of control angiographies in catheterization and intervention in complex anatomy, it can decrease the radiation dose.

Three-Dimensional Rotational Angiography in Congenital Heart Disease: Estimation of Radiation Exposure