IJMPCERO  Vol.7 No.4 , November 2018
Variability in Fluoroscopic Time during Interventional Non-Cardiac Procedures Performed Outside of the Radiology Department
Abstract: Purpose: Increasing physician awareness of patient exposure to radiation is an important step towards the reduction of potentially harmful effects of radiation. Published studies demonstrated that providing physicians with feedback regarding their fluoroscopy time leads to a reduction in average fluoroscopy times. The aim of this work was to analyze and publish our medical center data observed during the past year; fluoroscopy time (FT), Dose Area Product (DAP) and cumulative dose (CD) were monitored for radiation protection purposes. Methods: Fluoroscopy time is one of multiple radiation dose indices used in radiation safety auditing. Such auditing is nowadays turning into requirement of patient care safety and quality improvement; as indicated by accreditation bodies both nationally and internationally. All non-cardiac procedures performed outside radiology department by surgeons and interventionists are viewed. FT, DAP and CD are extracted for analysis. Results: a total of 846 cases were studied (643 orthopedic, 99 others, 73 urology, 17 chest, 7 vascular and 4 ERCP cases). Mean FT was 1.3 minutes, mean CD to the patient was 12.98 mGy and the mean DAP was 4.53 Gy/cm2. The longest FT noted was 55 min. The maximum CD was 904 mGy and the maximum DAP was 689 Gy/cm2. Using spearman’s correlation test we found out that there is a significant correlation between FT and DAP (correlation coefficient = 0.615, p. value < 0.001). There is a significant correlation between FT and CD (correlation coefficient = 0.628, p. value < 0.001). Conclusion: Information about FT that used in each procedure can be used as a tool for patient dose optimization. As we found a significant correlation between DAP as well as CD. Reducing fluoroscopic time (FT) is a radiation protection goal, since it serves the purpose of protection for both the patient and the workers.
Cite this paper: Harbi, M. , Malki, A. , Ahmari, S. and Soliman, K. (2018) Variability in Fluoroscopic Time during Interventional Non-Cardiac Procedures Performed Outside of the Radiology Department. International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, 7, 464-471. doi: 10.4236/ijmpcero.2018.74039.

[1]   Kim, S., Shin, J.H., Lee, J.W., Kang, H.S., Lee, G.Y. and Ahn, J.M. (2016) Factors Affecting Radiation Exposure during Lumbar Epidural Steroid Injection: A Prospective Study in 759 Patients. Korean Journal of Radiology, 17, 405-412.

[2]   Choi, M.H., Choi, B.G., Jung, S.E. and Byun, J.Y. (2016) Factors Related to Radiation Exposure during Lumbar Spine Intervention. Journal of Korean Medical Science, 31, S55-S58.

[3]   Miller, D.L., Balter, S., Schueler, B.A., Wagner, L.K., Strauss, K.J. and Vañó, E. (2010) Clinical Radiation Management for Fluoroscopically Guided Interventional Procedures. Radiology, 257, 321-332.

[4]   Balter, S., Hopewell, J.W., Miller, D.L., Wagner, L.K. and Zelefsky, M.J. (2010) Fluoroscopically Guided Interventional Procedures: A Review of Radiation Effects on Patients’ Skin and Hair. Radiology, 254, 326-341.

[5]   Lee, G., Hunter, R.J., Lovell, M.J., Finlay, M., Ullah, W., Baker, V., Dhinoja, M.B., Sporton, S., Earley, M.J. and Schilling, R.J. (2015) Use of a Contact Force-Sensing Ablation Catheter with Advanced Catheter Location Significantly Reduces Fluoroscopy Time and Radiation Dose in Catheter Ablation of Atrial Fibrillation. Ep Europace, 18, 211-218.

[6]   Madrigano, R.R., Abrão, K.C., Puchnick, A. and Regacini, R. (2014) Evaluation of Non-Radiologist Physicians’ Knowledge on Aspects Related to Ionizing Radiation in Imaging. Radiologiabrasileira, 47, 210-216.

[7]   Tsapaki, V., Tsalafoutas, I.A., Fagkrezos, D., Lazaretos, I., Nikolaou, V.S. and Efstathopoulos, N. (2015) Patient Radiation Doses in Various Fluoroscopically Guided Orthopaedic Procedures. Radiation Protection Dosimetry, 168, 72-75.

[8]   Malek, S., Davies, E., Malek, I.A., Rawal, A., Singh, A. and Harvey, R.A. (2007) Trauma Surgery and Risk of Radiation Injury to Patients. European Journal of Orthopaedic Surgery & Traumatology, 17, 23-28.

[9]   Tsalafoutas, I.A., Tsapaki, V., Kaliakmanis, A., Pneumaticos, S., Tsoronis, F., Koulentianos, E.D. and Papachristou, G. (2007). Estimation of Radiation Doses to Patients and Surgeons from Various Fluoroscopically Guided Orthopaedic Surgeries. Radiation Protection Dosimetry, 128, 112-119.

[10]   Chida, K., Saito, H., Otani, H., Kohzuki, M., Takahashi, S., Yamada, S., Shirato, K. and Zuguchi, M. (2006) Relationship between Fluoroscopic Time, Dose-Area Product, Body Weight, and Maximumradiation Skin Dose in Cardiac Interventional Procedures. American Journal of Roentgenology, 186, 774-778.

[11]   Shope, T.B. (1996) Radiation-Induced Skin Injuries from Fluoroscopy. Radiographics, 16, 1195-1199.

[12]   Skripochnik, E. and Loh, S.A. (2017) Fluoroscopy Time Is Not Accurate as a Surrogate for Radiation Exposure. Vascular, 25, 466-471.

[13]   McBride, J., Schueler, B., Oderich, G. and Misra, S. (2013) An Analysis of the Factors Influencing Radiation Dose and Fluoroscopic Time during Renal Stent Placement. Vascular and Endovascular Surgery, 47, 462-466.

[14]   Bucci, R.V., Gaisie, G., Cheryl Miller, R.T., Rubin, M. and Springer, A. (2014) Radiation Dose Reduction in Fluoroscopy. Radiology Management, 9-10.

[15]   Brady, Z. (2016) Radiation Dose in Fluoroscopy: Experience Does Matter. Journal of Medical Imaging and Radiation Oncology, 60, 457-458.