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Fluoroscopic Imaging Data Analysis: A Practical Study to Guide Protocol Optimization and Operator Training

J Paltani1*, G Fong2, K Wunderle2, (1) Cleveland State University, Cleveland, Ohio (2) Cleveland Clinic, Cleveland, Ohio

Presentations

TU-IePD-TRACK 2-4 (Tuesday, 7/27/2021) 12:30 PM - 1:00 PM [Eastern Time (GMT-4)]

Purpose: Fluoroscopy, 2D acquisition (2D-ACQ), and 3D acquisition (3D-ACQ) are fluoroscope imaging modes with substantially different radiation dose rates and image quality that may be used during fluoroscopically-guided interventions (FGIs). The purpose of this study was to analyze clinical procedure data to better understand imaging mode use frequency and its contribution to the reference point air kerma (K₍a,r₎) to potentially guide protocol optimization and focused educational opportunities.

Methods: 48,454 DICOM radiation structured dose reports originating from 59 interventional fluoroscopes in calendar year 2020 were analyzed in Excel. The data were parsed into four clinical groups performing FGIs , cardiac catheterization, cardiac electrophysiology, body-interventional, and neuro-interventional. The average percentage of irradiation events and average percentage of K₍a,r₎ per study from each imaging mode were calculated for each clinical service.

Results: Cardiac catheterization procedures resulted in fluoroscopy [85% of irradiation events, 65.8% of K₍a,r₎], 2D-ACQ [15% irradiation events, 34.2% of K₍a,r₎], and 3D-ACQ [0% of irradiation events, 0% of K₍a,r₎] from 19,439 procedures. Cardiac electrophysiology procedures resulted in fluoroscopy [97.6% of irradiation events, 85% of K₍a,r₎], 2D-ACQ [2.49% irradiation events, 15% of K₍a,r₎], and 3D-ACQ [0% of irradiation events, 0% of K₍a,r₎] from 6,125 procedures. Body-interventional procedures resulted in fluoroscopy [91.6% of irradiation events, 46.4% of K₍a,r₎], 2D-ACQ [8.1% of irradiation events, 44.5% of K₍a,r₎], and 3D-ACQ [0.3% of irradiation events, 9.1% of K₍a,r₎] from 20,198 procedures. Neuro-interventional procedures resulted in fluoroscopy [83.3% of irradiation events, 48.4% of K₍a,r₎], 2D-ACQ [16.3% of irradiation events, 48.6% of K₍a,r₎], and 3D-ACQ [0.4% of irradiation events, 3% of K₍a,r₎] from 2,692 procedures.

Conclusion: Institutions that perform FGI procedures may benefit from similarly analyzing their procedure data to better understand how the various imaging modes are used by different clinical services and use that data to guide protocol optimization and/or educational opportunities.

ePosters

    Keywords

    Fluoroscopy, Angiography

    Taxonomy

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

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