REGULAR CONTENT
Final ID
443
Type
Original Scientific Research-Oral or Pos
Authors
E Rinker1, S Joshi1, A Sever1, M Vanderhoek1, S Schwartz1
Institutions
1Henry Ford Hospital, Detroit, MI
Purpose
It is well established that with experience comes increased efficiency and decreased procedure time. Cardiology studies have shown that first year fellows can receive as much as 60% more radiation than their more senior counterparts [1]. We aim to evaluate and quantify differences in radiation exposure to patients and staff due to the presence of a fellow during interventional radiology cases.
Materials & Methods
Dose data for interventional radiology cases, both with and without a fellow, were compared at a teaching hospital from July 2015 to February 2016. For each case, kerma area product (KAP in Gy-cm^2) was used as a surrogate of total fluoroscopic radiation output and to represent patient dose. Individual staff doses were measured using the RaySafe i2 system, with dosimeter badges worn outside their lead vests. Only cases with a KAP greater than 20 Gy-cm^2 were considered, in order to minimize error introduced from badge accuracy. Staff positions include the attending, fellow, and scrub technologist. 101 cases were evaluated; 60 with a fellow, and 41 without.
Results
1. Average KAP for cases with a fellow was 54% greater than without (170.7 vs. 97.8 Gy*cm^2; p= 0.01).2. Average exposure to the fellow was 31% greater than to the attending working alone (20.7 vs. 15.1 uSv; p= 0.38).3. Average exposure to the attending was 47% greater when a fellow was present (24.4 vs. 15.1 uSv; p= 0.27).4. Average exposure to the scrub technologist was 44% greater when the fellow was present (8.6 vs. 5.5 uSv; p= 0.10).
Conclusions
Cases involving a fellow resulted in statistically significant increases in radiation exposure to the patient, as well as a trend towards statistically significant increases in exposure to the scrub technologist. Fellows and attendings experienced, on average, a higher dose when working together, though not statistically significant. This is perhaps best explained by the variability of interventional radiology cases, and by variable fellow involvement as principal operator. By being aware of these increases in radiation exposure during the training process, steps can be undertaken to minimize them; including appropriate training on fluoroscopic techniques and optimization of shielding.
Final ID
443
Type
Original Scientific Research-Oral or Pos
Authors
E Rinker1, S Joshi1, A Sever1, M Vanderhoek1, S Schwartz1
Institutions
1Henry Ford Hospital, Detroit, MI
Purpose
It is well established that with experience comes increased efficiency and decreased procedure time. Cardiology studies have shown that first year fellows can receive as much as 60% more radiation than their more senior counterparts [1]. We aim to evaluate and quantify differences in radiation exposure to patients and staff due to the presence of a fellow during interventional radiology cases.
Materials & Methods
Dose data for interventional radiology cases, both with and without a fellow, were compared at a teaching hospital from July 2015 to February 2016. For each case, kerma area product (KAP in Gy-cm^2) was used as a surrogate of total fluoroscopic radiation output and to represent patient dose. Individual staff doses were measured using the RaySafe i2 system, with dosimeter badges worn outside their lead vests. Only cases with a KAP greater than 20 Gy-cm^2 were considered, in order to minimize error introduced from badge accuracy. Staff positions include the attending, fellow, and scrub technologist. 101 cases were evaluated; 60 with a fellow, and 41 without.
Results
1. Average KAP for cases with a fellow was 54% greater than without (170.7 vs. 97.8 Gy*cm^2; p= 0.01).2. Average exposure to the fellow was 31% greater than to the attending working alone (20.7 vs. 15.1 uSv; p= 0.38).3. Average exposure to the attending was 47% greater when a fellow was present (24.4 vs. 15.1 uSv; p= 0.27).4. Average exposure to the scrub technologist was 44% greater when the fellow was present (8.6 vs. 5.5 uSv; p= 0.10).
Conclusions
Cases involving a fellow resulted in statistically significant increases in radiation exposure to the patient, as well as a trend towards statistically significant increases in exposure to the scrub technologist. Fellows and attendings experienced, on average, a higher dose when working together, though not statistically significant. This is perhaps best explained by the variability of interventional radiology cases, and by variable fellow involvement as principal operator. By being aware of these increases in radiation exposure during the training process, steps can be undertaken to minimize them; including appropriate training on fluoroscopic techniques and optimization of shielding.