Wunderle Kevin A, Jones A Kyle, Dharmadhikari Shalmali, Duan Xinhui, Kim Don-Soo, Mahmood Usman, Mann Steve D, Moirano Jeffery M, Neill Rebecca A, Schoenfeld Alan H
Department of Radiology, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195.
Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
J Vasc Interv Radiol. 2020 Oct;31(10):1545-1550.e1. doi: 10.1016/j.jvir.2020.04.023. Epub 2020 Aug 27.
To characterize the accuracy and consistency of fluoroscope dose index reporting and report rates of occupational radiation safety hardware availability and use, trainee participation in procedures, and optional hardware availability at pilot sites for the American College of Radiology (ACR) Fluoroscopy Dose Index Registry (DIR).
Nine institutions participated in the registry pilot, providing fluoroscopic technical and clinical practice data from 38 angiographic C-arm-type fluoroscopes. These data included measurements of the procedure table and mattress transmission factors and accuracy measurements of the reference-point air kerma (K) and air kerma-area product (P). The accuracy of the radiation dose indices were analyzed for variation over time by 1-way analysis of variance (ANOVA). Sites also self-reported information on availability and use of radiation safety hardware, hardware configuration of fluoroscopes, and trainee participation in procedures.
All K and P measurements were within the ±35% regulatory limit on accuracy. The mean absolute difference between correction factors for a given system in fluoroscopic and acquisition mode was 0.03 (95% confidence interval, 0.03-0.03). For the 28 fluoroscopic imaging planes that provided data for 3 time points, ANOVA yielded an F value of 0.134 with an F-critical value of 3.109 (P = .875).
This publication provides the technical and clinical framework pertaining to the ACR Fluoroscopy DIR pilot and offers necessary context for future analysis of the clinical procedure radiation-dose data collected.
描述美国放射学会(ACR)荧光透视剂量指数登记处(DIR)试点机构的荧光透视剂量指数报告的准确性和一致性,报告职业辐射安全硬件的可用性和使用情况、实习生参与程序的情况以及可选硬件的可用性。
九家机构参与了登记试点,提供了来自38台血管造影C形臂式荧光透视仪的荧光透视技术和临床实践数据。这些数据包括程序台和床垫传输因子的测量,以及参考点空气比释动能(K)和空气比释动能面积乘积(P)的准确性测量。通过单因素方差分析(ANOVA)分析辐射剂量指数的准确性随时间的变化。各机构还自行报告了辐射安全硬件的可用性和使用情况、荧光透视仪的硬件配置以及实习生参与程序的情况。
所有K和P测量值的准确性均在±35%的监管限值内。给定系统在荧光透视和采集模式下校正因子的平均绝对差值为0.03(95%置信区间,0.03 - 0.03)。对于提供三个时间点数据的28个荧光透视成像平面,ANOVA得出F值为0.134,F临界值为3.109(P = .875)。
本出版物提供了与ACR荧光透视DIR试点相关的技术和临床框架,并为未来分析所收集的临床程序辐射剂量数据提供了必要的背景信息。