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Fluoroscopic Dose Tracking: Trials, Tribulations, and Successes

R Fisher1*, O Christianson2*, B Schwarz3*, (1) MetroHealth, Cleveland, OH, (2) Landauer Medical Physics, Franklin Park, PA, (3) University of Florida, Gainesville, FL


(Wednesday, 7/15/2020) 1:00 PM - 3:00 PM [Eastern Time (GMT-4)]

Room: Track 4

With the Joint Commission’s establishment of new fluoroscopy requirements (effective January 1, 2019) addressing the capturing of radiation dose information and establishment of investigation and follow-up patient dose thresholds, fluoroscopic dose tracking, particularly for fluoroscopically-guided interventional (FGI) procedures, has become a prominent next step for compliance. Application of fluoroscopic dose tracking and patient follow-up can vary extensively by institution depending upon many factors including the specific imaging equipment, PACS, and electronic medical record (EMR) systems in use, the method of capturing radiation dose information, and the use or non-use and specific capabilities of any radiation dose tracking software.

Due to these factors, as well as administrative and physician roadblocks, institutions have had varying levels of success in instituting robust fluoroscopic dose tracking and associated hospital policy regarding patient dose thresholds and patient follow-up procedures. While some institutions have been able to institute large-scale fluoroscopic dose tracking through vendor solutions, clinical practice sites run the gamut from using manual dose tracking procedures where paper logs are completed by proceduralists or technologists present during the procedures to more automatic procedures which record cumulative air kerma in the patient EMR.

This set of presentations will provide examples of fluoroscopic dose tracking methods and associated hospital policy from different institution types (consulting physicist, in-house clinical physicist, university-based physicist) with discussion on what procedures and policies have succeeded (and which have failed) during implementation at their respective practice locations along with detailed examples of clinical workflow.

Learning Objectives:
1. Understand the Joint Commission requirements for fluoroscopic dose tracking.
2. Understand procedures and policies in place at certain institutions regarding fluoroscopic dose tracking and patient follow-up.
3. Understand administrative, technological, and physician-related roadblocks that can inhibit effective and efficient fluoroscopic dose tracking.



Fluoroscopy, Dose


IM- X-Ray: Fluoroscopy, digital angiography, and DSA

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