Skip to main content
Erschienen in: European Radiology 2/2021

Open Access 26.08.2020 | Interventional

Impact of interventionalist’s experience and gender on radiation dose and procedural time in CT-guided interventions—a retrospective analysis of 4380 cases over 10 years

verfasst von: Dorothea Theilig, Anna Mayerhofer, David Petschelt, Aboelyazid Elkilany, Bernd Hamm, Bernhard Gebauer, Dominik Geisel

Erschienen in: European Radiology | Ausgabe 2/2021

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To investigate the impact of the interventionalist’s experience and gender on radiation dose and procedural time in CT-guided interventions.

Methods

We retrospectively analyzed 4380 CT-guided interventions performed at our institution with the same CT scanner from 2009 until 2018, 1287 (29%) by female and 3093 (71%) by male interventionalists. Radiation dose, number of CT fluoroscopy images taken per intervention, total procedural time, type of intervention, and degree of difficulty were derived from the saved dose reports and images. All 16 interventionalists included in this analysis performed their first CT-guided interventions during the study period, and interventions performed by each interventionalist were counted to assess the level of experience for each intervention in terms of the number of prior interventions performed by her or him. The Mann-Whitney U test (MWU test), multivariate regression, and linear mixed model analysis were performed.

Results

Assessment of the impact of gender with the MWU test revealed that female interventionalists took a significantly smaller number of images (p < 0.0001) and achieved a lower dose-length product per intervention (p < 0.0001) while taking more time per intervention (p = 0.0001). This finding was confirmed for most types of interventions when additionally accounting for other possible impact factors in multivariate regression analysis. In linear mixed model analysis, we found that radiation dose, number of images taken per intervention, and procedural time decreased statistically significantly with interventionalist’s experience.

Conclusions

Radiation doses of CT-guided interventions are reduced by interventionalist’s experience and, for most types of interventions, when performed by female interventionalists.

Key Points

• Radiation doses in CT-guided interventions are lower when performed by female interventionalists.
• Procedural times of CT-guided interventions are longer when performed by female interventionalists.
• Radiation doses of CT-guided interventions decrease with the interventionalist’s experience.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Silverman SG, Deuson TE, Kane N et al (1998) Percutaneous abdominal biopsy: cost-identification analysis. Radiology 206:429–435CrossRef Silverman SG, Deuson TE, Kane N et al (1998) Percutaneous abdominal biopsy: cost-identification analysis. Radiology 206:429–435CrossRef
2.
Zurück zum Zitat Carlson SK, Bender CE, Classic KL et al (2001) Benefits and safety of CT fluoroscopy in interventional radiologic procedures. Radiology 219:515–520CrossRef Carlson SK, Bender CE, Classic KL et al (2001) Benefits and safety of CT fluoroscopy in interventional radiologic procedures. Radiology 219:515–520CrossRef
3.
Zurück zum Zitat Leng S, Christner JA, Carlson SK et al (2011) Radiation dose levels for interventional CT procedures. AJR Am J Roentgenol 197:W97–W103CrossRef Leng S, Christner JA, Carlson SK et al (2011) Radiation dose levels for interventional CT procedures. AJR Am J Roentgenol 197:W97–W103CrossRef
4.
Zurück zum Zitat Alves JG, Sarmento S, Pereira JS et al (2019) Dose to the interventional radiologist in CTF-guided procedures. Radiat Environ Biophys 58:373–384CrossRef Alves JG, Sarmento S, Pereira JS et al (2019) Dose to the interventional radiologist in CTF-guided procedures. Radiat Environ Biophys 58:373–384CrossRef
5.
Zurück zum Zitat Paulson EK, Sheafor DH, Enterline DS, McAdams HP, Yoshizumi TT (2001) CT fluoroscopy--guided interventional procedures: techniques and radiation dose to radiologists. Radiology 220:161–167CrossRef Paulson EK, Sheafor DH, Enterline DS, McAdams HP, Yoshizumi TT (2001) CT fluoroscopy--guided interventional procedures: techniques and radiation dose to radiologists. Radiology 220:161–167CrossRef
7.
Zurück zum Zitat Sadigh G, Khan R, Kassin MT, Applegate KE (2014) Radiation safety knowledge and perceptions among residents: a potential improvement opportunity for graduate medical education in the United States. Acad Radiol 21:869–878CrossRef Sadigh G, Khan R, Kassin MT, Applegate KE (2014) Radiation safety knowledge and perceptions among residents: a potential improvement opportunity for graduate medical education in the United States. Acad Radiol 21:869–878CrossRef
8.
Zurück zum Zitat Heyer CM, Peters S, Lemburg S, Nicolas V (2007) Awareness of radiation exposure of thoracic CT scans and conventional radiographs: what do non-radiologists know? Rofo 179:261–267CrossRef Heyer CM, Peters S, Lemburg S, Nicolas V (2007) Awareness of radiation exposure of thoracic CT scans and conventional radiographs: what do non-radiologists know? Rofo 179:261–267CrossRef
9.
Zurück zum Zitat Williams JR (1997) The interdependence of staff and patient doses in interventional radiology. Br J Radiol 70:498–503CrossRef Williams JR (1997) The interdependence of staff and patient doses in interventional radiology. Br J Radiol 70:498–503CrossRef
10.
Zurück zum Zitat Ciraj-Bjelac O, Antic V, Selakovic J, Bozovic P, Arandjic D, Pavlovic S (2016) Eye lens exposure to medical staff performing electrophysiology procedures: dose assessment and correlation to patient dose. Radiat Prot Dosimetry 172:475–482CrossRef Ciraj-Bjelac O, Antic V, Selakovic J, Bozovic P, Arandjic D, Pavlovic S (2016) Eye lens exposure to medical staff performing electrophysiology procedures: dose assessment and correlation to patient dose. Radiat Prot Dosimetry 172:475–482CrossRef
11.
Zurück zum Zitat Mohapatra A, Greenberg RK, Mastracci TM, Eagleton MJ, Thornsberry B (2013) Radiation exposure to operating room personnel and patients during endovascular procedures. J Vasc Surg 58:702–709CrossRef Mohapatra A, Greenberg RK, Mastracci TM, Eagleton MJ, Thornsberry B (2013) Radiation exposure to operating room personnel and patients during endovascular procedures. J Vasc Surg 58:702–709CrossRef
12.
Zurück zum Zitat Vano E, Gonzalez L, Guibelalde E, Fernandez JM, Ten JI (1998) Radiation exposure to medical staff in interventional and cardiac radiology. Br J Radiol 71:954–960CrossRef Vano E, Gonzalez L, Guibelalde E, Fernandez JM, Ten JI (1998) Radiation exposure to medical staff in interventional and cardiac radiology. Br J Radiol 71:954–960CrossRef
13.
Zurück zum Zitat Körner M, Linsenmaier U, Reiser MF, Wirth S (2010) Strategies for the reduction of exposure of medical staff in the CT operating room. Presented at European Congress of Radiology 2010, Vienna, Austria Körner M, Linsenmaier U, Reiser MF, Wirth S (2010) Strategies for the reduction of exposure of medical staff in the CT operating room. Presented at European Congress of Radiology 2010, Vienna, Austria
14.
Zurück zum Zitat Lucey BC, Varghese JC, Hochberg A, Blake MA, Soto JA (2007) CT-guided intervention with low radiation dose: feasibility and experience. AJR Am J Roentgenol 188:1187–1194CrossRef Lucey BC, Varghese JC, Hochberg A, Blake MA, Soto JA (2007) CT-guided intervention with low radiation dose: feasibility and experience. AJR Am J Roentgenol 188:1187–1194CrossRef
15.
Zurück zum Zitat Lamba R (2014) Radiation dose optimization for CT-guided interventional procedures in the abdomen and pelvis. J Am Coll Radiol 11:279–284CrossRef Lamba R (2014) Radiation dose optimization for CT-guided interventional procedures in the abdomen and pelvis. J Am Coll Radiol 11:279–284CrossRef
16.
Zurück zum Zitat Sarti M, Brehmer WP, Gay SB (2012) Low-dose techniques in CT-guided interventions. Radiographics 32:1109–1119 discussion 1119-1120CrossRef Sarti M, Brehmer WP, Gay SB (2012) Low-dose techniques in CT-guided interventions. Radiographics 32:1109–1119 discussion 1119-1120CrossRef
17.
Zurück zum Zitat Raman SP, Mahesh M, Blasko RV, Fishman EK (2013) CT scan parameters and radiation dose: practical advice for radiologists. J Am Coll Radiol 10:840–846CrossRef Raman SP, Mahesh M, Blasko RV, Fishman EK (2013) CT scan parameters and radiation dose: practical advice for radiologists. J Am Coll Radiol 10:840–846CrossRef
18.
Zurück zum Zitat Dias TR, Alves Junior J, Abdala N (2017) Learning curve of radiology residents during training in fluoroscopy-guided facet joint injections. Radiol Bras 50:162–169CrossRef Dias TR, Alves Junior J, Abdala N (2017) Learning curve of radiology residents during training in fluoroscopy-guided facet joint injections. Radiol Bras 50:162–169CrossRef
19.
Zurück zum Zitat Faulkner AR, Bourgeois AC, Bradley YC, Hudson KB, Heidel RE, Pasciak AS (2015) Simulation-based educational curriculum for fluoroscopically guided lumbar puncture improves operator confidence and reduces patient dose. Acad Radiol 22:668–673CrossRef Faulkner AR, Bourgeois AC, Bradley YC, Hudson KB, Heidel RE, Pasciak AS (2015) Simulation-based educational curriculum for fluoroscopically guided lumbar puncture improves operator confidence and reduces patient dose. Acad Radiol 22:668–673CrossRef
20.
Zurück zum Zitat Das R, Lucatelli P, Wang H, Belli AM (2015) Identifying the learning curve for uterine artery embolisation in an Interventional Radiological Training Unit. Cardiovasc Intervent Radiol 38:871–877CrossRef Das R, Lucatelli P, Wang H, Belli AM (2015) Identifying the learning curve for uterine artery embolisation in an Interventional Radiological Training Unit. Cardiovasc Intervent Radiol 38:871–877CrossRef
21.
Zurück zum Zitat Weyland CS, Hemmerich F, Mohlenbruch MA, Bendszus M, Pfaff JAR (2020) Radiation exposure and fluoroscopy time in mechanical thrombectomy of anterior circulation ischemic stroke depending on the interventionalist’s experience-a retrospective single center experience. Eur Radiol 30:1564–1570CrossRef Weyland CS, Hemmerich F, Mohlenbruch MA, Bendszus M, Pfaff JAR (2020) Radiation exposure and fluoroscopy time in mechanical thrombectomy of anterior circulation ischemic stroke depending on the interventionalist’s experience-a retrospective single center experience. Eur Radiol 30:1564–1570CrossRef
22.
Zurück zum Zitat Tekkis PP, Senagore AJ, Delaney CP, Fazio VW (2005) Evaluation of the learning curve in laparoscopic colorectal surgery: comparison of right-sided and left-sided resections. Ann Surg 242:83–91CrossRef Tekkis PP, Senagore AJ, Delaney CP, Fazio VW (2005) Evaluation of the learning curve in laparoscopic colorectal surgery: comparison of right-sided and left-sided resections. Ann Surg 242:83–91CrossRef
23.
Zurück zum Zitat Huang KH, Lan YT, Fang WL et al (2014) Comparison of the operative outcomes and learning curves between laparoscopic and robotic gastrectomy for gastric cancer. PLoS One 9:e111499CrossRef Huang KH, Lan YT, Fang WL et al (2014) Comparison of the operative outcomes and learning curves between laparoscopic and robotic gastrectomy for gastric cancer. PLoS One 9:e111499CrossRef
24.
Zurück zum Zitat Heusch P, Kropil P, Buchbender C et al (2014) Radiation exposure of the radiologist's eye lens during CT-guided interventions. Acta Radiol 55:86–90CrossRef Heusch P, Kropil P, Buchbender C et al (2014) Radiation exposure of the radiologist's eye lens during CT-guided interventions. Acta Radiol 55:86–90CrossRef
25.
Zurück zum Zitat Rathmann N, Haeusler U, Diezler P et al (2015) Evaluation of radiation exposure of medical staff during CT-guided interventions. J Am Coll Radiol 12:82–89CrossRef Rathmann N, Haeusler U, Diezler P et al (2015) Evaluation of radiation exposure of medical staff during CT-guided interventions. J Am Coll Radiol 12:82–89CrossRef
26.
Zurück zum Zitat Elsholtz FHJ, Vahldiek JL, Wyschkon S et al (2020) Radiation exposure of radiologists during different types of CT-guided interventions: an evaluation using dosimeters placed above and under lead protection. Acta Radiol 61:110–116CrossRef Elsholtz FHJ, Vahldiek JL, Wyschkon S et al (2020) Radiation exposure of radiologists during different types of CT-guided interventions: an evaluation using dosimeters placed above and under lead protection. Acta Radiol 61:110–116CrossRef
27.
Zurück zum Zitat Nawfel RD, Judy PF, Silverman SG, Hooton S, Tuncali K, Adams DF (2000) Patient and personnel exposure during CT fluoroscopy-guided interventional procedures. Radiology 216:180–184CrossRef Nawfel RD, Judy PF, Silverman SG, Hooton S, Tuncali K, Adams DF (2000) Patient and personnel exposure during CT fluoroscopy-guided interventional procedures. Radiology 216:180–184CrossRef
28.
Zurück zum Zitat Gupta S, Wallace MJ, Cardella JF et al (2010) Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol 21:969–975CrossRef Gupta S, Wallace MJ, Cardella JF et al (2010) Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol 21:969–975CrossRef
29.
Zurück zum Zitat Pradella M, Trumm C, Stieltjes B, Boll DT, Zech CJ, Huegli RW (2019) Impact factors for safety, success, duration and radiation exposure in CT-guided interventions. Br J Radiol 92:20180937CrossRef Pradella M, Trumm C, Stieltjes B, Boll DT, Zech CJ, Huegli RW (2019) Impact factors for safety, success, duration and radiation exposure in CT-guided interventions. Br J Radiol 92:20180937CrossRef
Metadaten
Titel
Impact of interventionalist’s experience and gender on radiation dose and procedural time in CT-guided interventions—a retrospective analysis of 4380 cases over 10 years
verfasst von
Dorothea Theilig
Anna Mayerhofer
David Petschelt
Aboelyazid Elkilany
Bernd Hamm
Bernhard Gebauer
Dominik Geisel
Publikationsdatum
26.08.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 2/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07185-x

Weitere Artikel der Ausgabe 2/2021

European Radiology 2/2021 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.