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Dosimetric Performance of Fluoroscopes Participating in the American College of Radiology Fluoroscopy Dose Index Registry Pilot

K Wunderle1*, A Jones2, S Dharmadhikari3, X Duan4, D Kim5, U Mahmood6, S Mann7, J Moirano8, R Neill9, A Schoenfeld10, (1) Cleveland Clinic Foundation, Broadview Hts, OH, (2) UT MD Anderson Cancer Center, Houston, TX, (3) Emory University, Atlanta, GA, (4) UT Southwestern Medical Center, Dallas, TX, (5) Boston Childrens Hospital / Harvard Medical School, Boston, MA, (6) Memorial Sloan Kettering Cancer Center, Lynbrook, NY, (7) Duke University Health System, Durham, NC,(8) University of Washington, Seatle, WA, (9) Emory University, Atlanta, GA, (10) Montefiore Medical Center, Bronx, NY


(Sunday, 7/12/2020) 11:30 AM - 12:30 PM [Eastern Time (GMT-4)]

Room: Track 1

Purpose: summarize the fluoroscope dosimetric performance and radiation protection hardware use data collected and analyzed for the ACR Fluoroscopy Dose Index Registry (DIR) pilot.

Methods: AAPM TG 190 methodology were used to collect dosimetric performance data for 38 angiographic C-arm fluoroscopes from nine institutions that participated in the the ACR Fluoroscopy DIR pilot. Data collected included periodic accuracy measurements of the displayed reference air kerma (Ka,r) and kerma-area product (PKA) and two sets of measurements for the procedure table and mattress transmission factor, one free-in-air using narrow beam geometry and the other at the mattress surface using broad beam geometry. Additional data regarding radiation protection hardware availability and clinical use were collected using a questionnaire.

Results: average Ka,r correction factors (ratio of measured to indicated values) were 0.94 (95% CI, 0.92-0.96) and 0.95 (95% CI, 0.93-0.96) for fluoroscopic and acquisition modes, respectively. The absolute differences between the Ka,r and PKA measurements made on a given system using the fluoroscopic versus acquisition mode yielded a mean difference of 0.03. A one way ANOVA indicated that the correction factors for both modes were stable over the course of the 18 month data collection period. The average procedure table and mattress transmission factors were 0.70 and 0.76 for the free-in-air and mattress surface measurements, respectively. Suspended (pull-down) radiation shields and table skirts were available for all systems, while more than half of the systems did not have table side shields available. Use of available radiation shields varied considerably across participants.

Conclusion: dosimetric performance of fluoroscopes contributing data to the ACR Fluoroscopy DIR pilot indicate stable and generally accurate fluoroscope reported dose indices. Although most systems had sufficient radiation protection hardware available, use was inconsistent.


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