Özhan ÖZGÜR, Cemil OKTAY, Demet GÜNDÜZ, Erhan HEPERENLER, Hakkı Timur SİNDEL
Diagnostic and Interventional Radiology - 2026;32(4):487-491
PURPOSE To evaluate the effectiveness of the spot region of interest (ROI) technique in reducing radiation exposure during fluoroscopically guided venous access procedures in pediatric patients. METHODS This retrospective study included pediatric patients who underwent central venous access procedures in an interventional radiology unit of a tertiary care center. Data collected included patient demographics, procedure type, target vein, dose area product (DAP), cumulative dose, fluoroscopy time, and the DAP/fluoroscopy time ratio. RESULTS A total of 131 patients (mean age: 8 +/- 4.91; 48.9% women) were included, of whom 44 (33.6%) underwent procedures using the spot ROI technique. The spot ROI group demonstrated significantly lower DAP and cumulative dose than the non-ROI group (reduction ratios: 63.8% and 67.2%, respectively, P < 0.001 for all). When normalized to fluoroscopy time, the DAP/fluoroscopy time ratio was also significantly reduced in the spot ROI group [15.34 (7.18-23.57) vs. 25.17 (18.49-42.03); P < 0.001]. CONCLUSION Spot ROI is an effective and safe technique for reducing radiation exposure during pediatric venous access procedures without compromising procedural success. Given the high radiation sensitivity of pediatric patients and the potential need for repeated interventions in those with chronic conditions, spot ROI represents a valuable tool for dose optimization and aligns with the As Low As Reasonably Achievable (ALARA) principle.
