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Tracking, Feedback Reduce Dose in Pediatric Fluoroscopy


Radiologists can decrease dose from pediatric fluoroscopy through dose tracking with feedback, and training.

Radiation dose from pediatric fluoroscopic procedures can be reduced by almost half with radiation dose tracking with feedback and dose reduction training, according to a study published in the Journal of the American College of Radiology.

Researchers from the University of Pittsburgh Medical Center in Pennsylvania sought to determine the efficacy of dose tracking and dose reduction training in reducing radiation use in common pediatric diagnostic fluoroscopy procedures.

The study took place over a 12-month period. For the first six months, researchers recorded fluoroscopy time and radiation dose area product (DAP) for 945 procedures, which included upper GIs, voiding cystourethrograms (VCUGs), and barium enemas. The results were then presented to radiologists who followed a one-hour training session on radiation dose reduction methods. Data were recorded for 530 procedures for an additional six months.

The results showed no statistically significant differences in patient age, proportion of examination types, or fluoroscopy time between the pre- and post-training groups, with the exception of a small decrease in median fluoroscopy time for VCUGs (1.0 versus 0.9 minutes).[[{"type":"media","view_mode":"media_crop","fid":"43210","attributes":{"alt":"radiation dose","class":"media-image media-image-right","id":"media_crop_1871516953644","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4707","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 113px; width: 120px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"©Preecha TH/Shutterstock.com","typeof":"foaf:Image"}}]]

There was a statistically significant decrease in the median normalized DAP between pre- and post-training groups for all examination types.

Median (quartiles) for pretraining and post-training normalized DAPs (μGy·m2 per minute):

Upper GIs
14.36 (5.00, 38.95)
6.67 (2.67, 17.09)
Voiding cystourethrograms
13.00 (5.34, 32.71)
7.16 (2.73, 19.85)
Barium enemas
33.14 (9.80, 85.26)
17.55 (7.96, 46.31)

“Radiation dose tracking with feedback, paired with dose reduction training, can reduce radiation dose during diagnostic pediatric fluoroscopic procedures by nearly 50 percent,” the authors wrote.

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