Room: Exhibit Hall | Forum 8
Purpose: To investigate repeat fluoroscopically guided interventional (FGI) procedures performed on the same patient and the associated radiation dose utilization, over a 5-year period at a tertiary healthcare center.
Methods: IRB approved this retrospective review. Data for all FGI procedures performed in Philips interventional radiology suites at this tertiary care center over a 5-year period were extracted from Centricity RIS-IC (GE Healthcare); and analyzed using IBMâ€™s SPSS package.
Results: 10,422 patients underwent any one of the 94 unique FGI procedures cumulating to 22,414 encounters. While 6,405 patients had any procedure performed only once, there were 4,017 patients that underwent an FGI procedure more than once, with the number of procedural-encounters ranging from 2 to 54. Data from 1,842 patients with 2 encounters and 776 patients with 3 encounters showed that PICC placement was the most common procedure with mean cumulative air kerma (CAK) and kerma-area-product (KAP) of 26mGy and 7,326mGy.cmÂ², and 19mGy and 8,478mGy.cmÂ², respectively. In 435 patients with 4 encounters, and 261 patients with 5 encounters, chemo/immuno-embolization was the most common procedure with relatively high mean CAK and KAP of 776mGy and 294,107mGy. cmÂ², and 935mGy and 307,623mGy.cmÂ², respectively. From the remaining, 697 patients had number of encounters ranging from 6 to 30, and even in this group, chemo/immuno-embolization was the most common procedure with mean CAK of 404mGy and KAP of 167,760mGy.cmÂ²; the drop in mean CAK and KAP may be due to familiarity with the patientâ€™s anatomy and physiology or due to equipment upgrades or both. For the remaining 6 patients who had 32 to 54 procedural-encounters, the mean CAK and KAP ranged from 21-138 mGy and 12,756-41,573 mGy.cmÂ², respectively, indicating encounters utilizing low radiation dose.
Conclusion: Analysis provides an insight on radiation dose utilization, and motivation for radiation dose optimization, specifically, for patients undergoing repeat procedures.