Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Augustenburger Platz 1, 13353, Berlin, Germany.
Eur Radiol. 2021 Feb;31(2):569-579. doi: 10.1007/s00330-020-07185-x. Epub 2020 Aug 26.
To investigate the impact of the interventionalist's experience and gender on radiation dose and procedural time in CT-guided interventions.
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.
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.
Radiation doses of CT-guided interventions are reduced by interventionalist's experience and, for most types of interventions, when performed by female interventionalists.
• 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.
探讨介入医师经验和性别对 CT 引导介入中辐射剂量和手术时间的影响。
我们回顾性分析了 2009 年至 2018 年在我院使用同一台 CT 扫描仪进行的 4380 例 CT 引导介入，其中 1287 例（29%）由女性介入医师完成，3093 例（71%）由男性介入医师完成。从保存的剂量报告和图像中得出辐射剂量、每次介入所拍摄的 CT 透视图像数量、总手术时间、介入类型和难度。本分析中纳入的 16 名介入医师均在研究期间完成了他们的首次 CT 引导介入，每位介入医师所进行的介入次数用于评估其每位介入医师的经验水平。采用 Mann-Whitney U 检验（MWU 检验）、多变量回归和线性混合模型分析。
MWU 检验评估性别影响的结果显示，女性介入医师拍摄的图像数量明显减少（p < 0.0001），每次介入的剂量长度乘积也明显降低（p < 0.0001），而每次介入的时间则明显延长（p = 0.0001）。当在多变量回归分析中另外考虑其他可能的影响因素时，这一发现也适用于大多数类型的介入。在线性混合模型分析中，我们发现辐射剂量、每次介入拍摄的图像数量和手术时间随着介入医师经验的增加而呈统计学显著下降。
CT 引导介入的辐射剂量随介入医师经验的增加而降低，对于大多数类型的介入，女性介入医师进行的介入辐射剂量也会降低。
CT 引导介入的辐射剂量在女性介入医师进行时较低。
CT 引导介入的手术时间在女性介入医师进行时较长。
CT 引导介入的辐射剂量随介入医师经验的增加而降低。
